Date of Award
Doctor of Philosophy (PhD)
Over 7 million children and youth have a diagnosable mental illness any given year. There are evidence-based treatments (EBTs) to effectively treat these conditions, but these EBTs reach a very small percentage of their target population with treatment rates between 1-3%.1 We know very little about what influences these coverage rates. Beginning in 2009, the Los Angeles County Mental Health Department (LACDMH) began an ambitious agenda to scale-up the provision of EBTs in child/youth mental health care. The present study seeks to contribute to the scale-up literature by examining three questions based on LACDMH’s initiative: 1) To what extent have the county’s selected EBTs reached their target population?; 2) Are there differences in coverage rates within the county?; and 3) What factors are associated with the coverage rates? To answer these questions, the author used small area variation analysis and geospatial methods to create coverage scores at the county, service planning area, and clinic service area levels. The author aggregated community and clinic characteristics to the clinic service area level (n=254) to assess factors related to coverage. The author used LACDMH administrative claims data for FY 2013-2014 with population data from the American Community Survey 2014 5-yr estimates (ACS). The county reached 17% of its target population during FY 2013-2014. Coverage varied throughout the county. OLS regression results indicated that the proportion of ethnic minorities, immigrants and adults with a college degree were negatively associated with clinic service area coverage scores.
Chair and Committee
Enola K. Proctor
Ross C. Brownson, Patrick J. Fowler, Derek S. Brown, Deborah Salvo,
Hooley, Cole Douglas, "Scaling-up Child and Youth Mental Health Services: Assessing Coverage of a County-wide Initiative" (2019). Arts & Sciences Electronic Theses and Dissertations. 1911.