(PS5-96) Understanding the Relationship Between Racial Identity, Caregiver Satisfaction, and Youth Outcomes Within Community-based Wraparound Programming

Background:  Wraparound is a community-based intensive, individualized care coordination model for youth experiencing serious mental health and behavioral challenges. Wraparound care coordinators address the needs of youth and their families by connecting them to mental health resources including cognitive behavioral therapy (CBT), Multisystemic therapy (MST), parenting training, and other evidence-based practices. A 2021 meta-analysis found an association between participation Wraparound and positive youth outcomes including improved school functioning, residential placement outcomes, mental health functioning, and mental health symptoms. However, there may be desperate outcomes within populations of youth served. This study examines the association between racial identity, caregiver satisfaction, and youth outcomes: suspension/expulsion, emergency visits, new placement in an institution, and negative contact with the police.

Methods: Analysis was conducted as a secondary analysis of surveys that were collected from 276 caregivers, as part of a state-wide Wraparound initiative. Data were gathered using the Wraparound Fidelity Index Short Form for Caregivers (WFI-EZ), a caregiver self-report measure that includes youth race as identified by the caregiver, caregiver satisfaction, and various youth outcomes. Participants were randomly sampled from currently enrolled youth in the state-wide Wraparound program, and data were collected using a mixed methods approach, including phone calls, emails, texts, and mailers.

Results: Youth that identified as Black/African American (n = 16) had overall higher program satisfaction scores (X̄ = 71.2%) when compared with their White/Caucasian (n = 125, X̄ = 68%) and Multi-Racial (n = 25, X̄ = 56.8%) peers. However, youth outcomes trended in the opposite direction. Between group analysis showed that racial groups had significantly different suspension/expulsion rates [F(3, 37%) = 7.36, p< 0.01], with Black/African American youth having the highest suspension/expulsion rates (72%) as compared to their White/Caucasian (30%) and Multi-Racial (25%) peers.  

Conclusion: There are many components to engagement of families in community mental health services and the results discussed demonstrate the complexity of various evaluation outcomes. Additional information is needed to understand if why caregivers of Black/African American youth were rated higher and the impact of participation in Wraparound on likelihood of expulsion rates. Future research may consider the impact of racial concordance on satisfaction, additional context of qualitative data from caregivers about their experiences, and a more extensive battery to assess the broadness family experiences while engaging in community mental health services.