Wraparound care coordination supports the needs of youth with a range of complex behavioral health needs, although some outcomes and implementation activities vary for youth with different needs.

Background

Intensive care coordination using Wraparound is a comprehensive, team-based, and strengths-based approach to supporting children and youth with complex behavioral health needs and their families. While the Wraparound approach has been shown to support positive clinical and social outcomes, less research has been done to investigate differential impact among Wraparound program participants with differing needs. This study assessed patterns of need for youth enrolled in a state Wraparound program, as well as implementation and impact differences of the program across different categories of need.

Findings

Using data from 1,243 families participating in a state Wraparound care coordination program, this study assessed patterns of need for enrolled youth. Based on caregiver survey data at program intake, this study identified five categories of need: (1) behavioral problems, (2) behavior problems/needs and ADHD, (3) educational needs, (4) mental health needs, and (5) multi-needs. All categories showed positive outcomes six months post-enrollment compared to baseline on measure of mental health outcomes, functioning, and caregiver strain (not tested for statistical significance). All outcomes categories showed some statistically significant differences by categories of need. For example, the mental health needs group had the greatest decrease in problem behaviors and trauma symptoms compared to other classes, while caregivers of youth with multi-needs saw the least decrease in caregiver strain compared to other groups. There was also variation between some groups on characteristics of Wraparound activities (e.g., number of meetings, participants in care coordination meetings).

Program/Policy Takeaways

This study suggests that while Wraparound care coordination is beneficial for youth with a variety of complex behavioral health needs and their families, experiences and outcomes can vary between groups. This analysis underscores the need for an individualized approach to care coordination. Additional research is needed to further explore how to best meet the needs of youth with different behavioral health needs.