This special topic report examines the prevalence and characteristics of co-occurring substance abuse and mental health problems among adult arrestees in Maricopa County. The findings suggest that more than 28 percent of adult arrestees in Maricopa County are at risk for a co-occurring disorder, and they face significantly greater difficulties across a number of critical factors, including incarceration, homelessness, and victimization. Understanding the prevalence and particular characteristics of the dual-diagnosed arrestee population in Maricopa County is an important part of assessing demands on behavioral health and substance use treatment resources. Additionally, examining some of the current defining characteristics of this population relative to arrestees not dually diagnosed can serve as an indicator of future demand.

This special topic report examines the prevalence and characteristics of co-occurring substance abuse and mental health problems among juvenile detainees in Maricopa County. The findings come from the Co-occurring Disorder Addendum used during 2007. The findings reveal that almost 30 percent of juvenile detainees were at risk for a co-occurring disorder, and face significantly greater difficulties across a number of critical factors, including incarceration, homelessness, and victimization.

Severe and widespread budget cuts in behavioral health and substance abuse services for lower-income Arizonans who don’t qualify for AHCCCS have already taken effect across the state. Even before these cuts were implemented, it was clear that the publicly-supported behavioral health system in our state was not adequately serving many Arizonans who needed mental health or substance use disorder treatment. This paper represents an effort by Arizona State University’s Centers for Applied Behavioral Health Policy and the Morrison Institute for Public Policy to promote and enrich Arizona’s public dialogue about these problems and potential solutions.

Arizona’s public behavioral health care system, which serves some 150,000 mentally ill and vulnerable state residents, is wrestling with a number of urgent challenges. In addition to budget cuts resulting from the current economic crisis, and the demands of a 28-year-old class-action lawsuit, the system has been repeatedly criticized in several areas, including for inadequate staff, data, housing support, and crisis services. On July 22, a panel of professionals who play key roles in the system discussed these and other issues before some 300 behavioral health providers, supervisors, and policymakers at the annual Summer Institute hosted by Arizona State University’s Center for Applied Behavioral Health Policy. This paper provides an abbreviated report of that discussion, which was partially designed and moderated by ASU’s Morrison Institute for Public Policy.

The Division of Adult Education in the Arizona Department of Education and the Arizona Adult Literacy and Technology Resource Center contracted with the Morrison Institute for Public Policy to develop an evaluation system for Arizona's adult education program. During phase I, the institute analyzed existing program data on Arizona's adult education providers. Interviews were conducted in January and February 1997 of 379 current and past program participants; they were done in English or Spanish, as appropriate. Interviewees were asked 10 questions about reasons for entering the program, amount of time spent in the program, and feelings about what the program did or did not help them accomplish. Past participants were asked an additional question about their reasons for leaving the program. Findings indicated that over 90 percent of interviewees felt their adult education experiences had met their needs and been positive overall. The proportions of participants who mentioned having entered with a specific goal, e.g., preparing to take the General Educational Development tests or to get a job, were closely aligned with the proportions who said their participation in the program had helped them reach that particular goal. More than one-quarter of program participants in 1996 showed improvement on three indicators that suggested they were becoming more self-sufficient: moving off public assistance, gaining employment, and maintaining or improving their job situation. (Appendixes contain 10 references, 3 data tables, and interview forms.)

In preparation for new federal legislation that promotes unprecedented levels of comprehensive planning and service integration at state and local levels, an analysis of state issues relevant to comprehensive service delivery is necessary. This paper examines such state issues, with a focus on Arizona's at-risk population, and presents a framework for comprehensive service delivery. It provides the rationale for such service delivery, summarizes the literature on research-based practices, illustrates district approaches to comprehensive service delivery, and sets forth guidelines for developing a comprehensive plan. System components of an effective plan are discussed in detail--student education, parent/family involvement, social/economic services, health services, and professional development. Five general principles underlie success: philosophy, people, processes, promising practices, and partners. Recommendations for developing comprehensive service delivery programs include the following: (1) build on existing information; (2) consolidate knowledge; and (3) think long-term. Contains 11 figures and over 250 references. Appendices contain information on Arizona practitioners' views and an illustration of a side-by-side program analysis.

Arizona's Serve-America program, administered by the Arizona Department of Education (ADE), began in fiscal year 1992-93 under the auspices of the National and Community Service Act of 1990. Serve-America links community service projects with schools and youths in grades K-12. This second annual report documents the second year of project implementation and updates the policy context in which programs are operating. It focuses on 15 sites--including both schools and community-based organizations--funded to implement community service programs during 1993-94. A pre- and post-test study investigated the relationship between "at-riskness" and "connectedness to the community." Findings indicate that the projects made considerable progress toward accomplishing proposed goals and resulted in positive outcomes for local communities and student volunteers, particularly those at risk. Some projects were more effective than others in positively influencing at-risk participants. The following recommendations are offered: (1) the ADE should continue to support community service programs; (2) the ADE should sponsor more technical assistance and evaluation training; (3) the state should expand training and assistance; and (4) further research about Arizona's effective community service projects is warranted.

The Phoenix Early Head Start (EHS) program is a family-centered program intended to provide early, continuous, intensive, and comprehensive child development and family support services for first-time teen parents and their very young children. This report presents case studies of 12 families, all EHS participants, who agreed to be followed throughout their participation in the program so that their stories could be updated as they unfolded from one year to the next. The case study families were interviewed in August of 1997, 1998, and 1999. Four of the families had participated in the first two interviews but had withdrawn prior to the third interview. Additional information was obtained through conversations with family support specialists in May 2000. Common themes in the families' stories regarding EHS's role include: (1) assistance from caring staff; (2) reassurance from home visits and child development; (3) help in becoming good parents; (4) help with personal goals; (5) help with daily life; and (6) socialization opportunities for children and parents. During the study, most families made progress to widely differing degrees. Although somewhat apprehensive about life without the safety net of EHS, all eight families seemed much more confident than earlier, had some knowledge and understanding of their children and themselves, and had articulated and taken some steps toward achieving personal and family goals.

Amidst the numbers and statistics that comprise a program evaluation, it is easy to lose sight of the program participants themselves. That is one rationale for a case study--to tap into some of the rich background information that only participants can provide. To develop some of this background information for the five-year program evaluation of Phoenix Early Head Start(EHS), a case study was undertaken of 12 families who were representative of all EHS program participants. Each of the 12 families agreed to be followed throughout their participation in the program so that their "stories" can be updated as they unfold from one year to the next.

The Phoenix, Arizona Early Head Start program is a family-centered program providing early, continuous, intensive, and comprehensive child development and family support services for low-income pregnant women and families with children ages birth to three. Analyses were conducted of program and participant data and program processes from Year 3, the second full year of implementation. The program components evaluated were: (1) child development, promoted through weekly home visits, site-based socialization activities, and weekly play groups; (2) family development services, provided by family support specialists to develop effective, supportive relationships, especially with fathers; (3) staff development, incorporating a multi-disciplinary approach reinforced by a relationship-based supervision model; and (4) community building and collaboration, including connections with Phoenix's program for young fathers and other family-focused initiatives.

Evaluation findings suggest that the program is on the right track. Among the program's successes are the launch of all planned child development activities, increased services by and access to the child development/disabilities specialists, and progress made through the male involvement component. The program continues to face challenges, including increasing staff skills in child development and parent-child relationships, helping young parents adjust to dealing with toddlers, reducing disruptive effects of staff turnover, and making the program and participants visible and vital to other family-centered community endeavors and to policy makers. Recommendations for future operations were derived from the evaluation findings. (Contains 49 references.)