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The wraparound services model for behavioral health care has been around since the 1980s.
Since then, it’s become more widely adopted. Nearly two-thirds of states currently provide centralized oversight for wraparound programs, and it’s estimated that more than 100,000 youths receive wraparound services annually.
Yet despite its growing popularity, the need for wraparound and intensive case management services continues to increase. Fifteen million children and adolescents in the U.S. have a diagnosable mental health disorder, and roughly half experience serious emotional disturbances (SED), which impair their overall functioning. The wraparound model aims to support these children and adolescents experiencing severe behavioral health conditions by leveraging each client’s unique strengths and natural supports in their community with individualized care planning.
But how effective are wraparound services? Is the investment in this time-intensive care model paying off for communities?
The data suggests that while this model may require more resources and intensive care coordination, high-fidelity wraparound services are highly effective. This article will summarize fundamental research studies that have reviewed the efficacy of wraparound over the years.
The Need For Continued Study
Before we explore the literature, it’s worth noting researchers’ concerns about how accurately the wraparound model is deployed in different communities.
Social scientists have been evaluating the wraparound model since the 90s to determine whether it’s more or less effective than traditional case management methodologies. While numerous studies emphasize the positive impact of wraparound services, some researchers note that the service model’s implementation lacks consistency. Therefore, some studies point out that future research should account for the level of fidelity that wraparound providers are adhering to while studying the long-term impacts.
For example, a 2021 systematic review and meta-analysis of previous research about wraparound outcomes acknowledged that while “results indicate positive effects for wraparound, particularly for maintaining youth with severe emotional disturbances in the home and community […] many studies showed methodological weaknesses, and fidelity measurement was largely absent, suggesting a need for additional research.”
While wraparound research studies may lack consistency in how data is collected and evaluated, individual studies do show promising results.
Research Shows High-Fidelity Wraparound Services are Evidence-Based and Effective
In 2007, researchers published results from an 18-month comparison study conducted in Nevada that evaluated 33 youths receiving wraparound. Within the study period, the mean Child and Adolescent Functional Assessment Scale (CAFAS) scores decreased significantly for youth receiving wraparound services when compared to those receiving less intensive case management interventions. In addition, the wraparound cohort showed improvements in school attendance, grade point averages, and decreased disciplinary action at school.
More recently, a 2018 Australian study published in Early Intervention in Psychiatry pointed to correlations between wraparound behavioral health care and reduced rates of reliance on emergency department visits and inpatient mental health services. On average, youth receiving wraparound in this study spent 62% less time in institutional settings, resulting in over $2 million in health cost savings. The researchers concluded that wraparound “has the potential to offer improved clinical outcomes, significant cost savings over time, improved coordination between care providers, and an alternative to detention or incarceration.”
Researchers have also examined longitudinal data to examine the effects of wraparound services over longer periods of time. A 2019 study published in the Journal of Emotional and Behavioral Disorders reviewed more than five years of public systems data. The researchers’ findings showed that wraparound care reduced youth reliance on residential treatment. Instead of receiving inpatient care, youth in wraparound programs relied more on outpatient therapy.
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How to Provide High-Fidelity Wraparound Services
Many organizations, systems of care, and continuums of care providing wraparound services rely on case management software to manage complex behavioral health cases – yet not all software solutions can accommodate the specific nuances of high-fidelity wraparound.
Cloud-based case management software, like CaseWorthy, gives wraparound care providers the tools, flexibility, and ease of use they need. With CaseWorthy, wraparound case managers can easily:
- Engage the Youth, Family, and Team Members to Participate
- Securely Communicate with Team Members
- Coordinate Social Service Delivery, Setting Frequency, Automated Check-In Reminders, and Rules
- Quickly Find Referrals Based On Distance to Client
- Manage Workflows and Plans of Care Management
- Create Their Own Training Videos In CaseWorthy
- Quickly Generate Custom Reports
CaseWorthy’s Flexible Platform Helps Wraparound Providers Manage Data, Deliver Programs, and Measure Impact
CaseWorthy is more than just a database. It’s a customizable tool that case managers and nonprofit personnel use to intake new clients, track case progress, and report out with ease.
