FY25: HFY1: During HFY1, 0%, or 0 of 2 youth/young adults, who were not in school and/or working at MST-EA entry were working and/or in school at discharge.  treatment.  Clients 69 and 76 were not working or in school at MST-EA program start or at program discharge. Client 69 was able to briefly gain employment during treatment, however, the client was unable to maintain this employment after going to a multi-day conference with the employer and getting into a conflict with the employer. Shortly after returning, the client was discharged from their housing placement and was unsuccessful with identifying stable housing before asking to discharge from services. The client also had a brief hospitalization during treatment, but ultimately stopped taking medications, continued substance use and was unable to effectively manage mental health, all presenting as barriers to employment. At the time of discharge, the team provided the client’s worker with information on services to address the client’s mental health and substance use as they needed to be addressed, along with housing, before the client would be able to successfully enroll in school or gain and maintain employment. Client 76 was unable to gain employment throughout treatment and had been very minimally engaged from the initiation of services. Despite the client being on GPS monitoring, the client was often not home for scheduled sessions and did not have a method of communication (e.g., cell phone) to be able to reach him to attempt to meet in the community. The client removed his GPS monitor and went AWOL before the team was able to support with any school or employment related goals, or any other treatment goals. Client 76 was ultimately arrested and placed in a restrictive placement.  HFY2: During HFY2 0 of 3, or 0% of youth/young adults, who were not in school and/or working at MST-EA entry were working and/or in school at discharge. Clients 75, 88 and 91 were not working or in school at MST-EA program discharge. Client 75 did not have employment by the end of treatment, but did take important prerequisite steps while in treatment to include creating a resume, establishing a more professional email, and applying to jobs. As identified above, this client was no longer able to commit to taking part in services, and may have been working non-traditional employment by the end of services, however, this was not able to be confirmed. Client 88 did not obtain employment while in in the MST-EA program, however, the client was working with another program that focused on vocational skills and opportunities. Client 91 had not been able to gain employment during the short time working with the client before having been removed due to administrative reasons, as discussed above. 

Annual:  During the FY25 0 of 5 or 0% of youth/young adults who were not in school and/or working at MST-EA entry were working and/or in school at discharge. 

In school and/or employed is defined as youth/young adult is attending school, a high school equivalency degree (GED) program, a vocational program, or is working at least part-time at client discharge as measured by school and/or work attendance records and client self-report.

Partners:

• MD Department of Juvenile Services
• Baltimore County Detention Center
• Baltimore County Court System
• Baltimore County Office of the Public Defender
• Baltimore County Department of Social Services
• Community Solutions, Inc.
• Prologue, Inc.

What Works:

MST-EA is a manualized treatment that is an adaptation of the evidence-based treatment, Multi-Systemic Therapy (MST). MST-EA treatment targets are achieved by changing how clients function in their natural settings (home, school, community), leveraging the client’s strengths, pulling in positive supports, and developing the client’s skills and resources to overcome barriers to success.  Evidence-based interventions (e.g., cognitive behavioral therapy, behavioral interventions, motivational interviewing, affective education) are used to address treatment needs.

FY25: Client is attending school, a high school equivalency degree (GED) program, a vocational program, or is working at least part-time at client discharge as measured by school and/or work attendance records and client self-report.

FY24: During FY24, 5 of 12 or 42% of youth/young adults who were not in school and/or working at MST-EA entry were working and/or in school at discharge.

A total of 100% or 3 of 3 youth/young adults that were NOT actively enrolled in school and/or employed when beginning MST EA were actively enrolled in school and/or employed at program discharge during FY22.

Definitions:

In school and/or employed:  EA is attending school, a high school equivalency degree (GED) program, a vocational program, or is working at least part-time at client discharge as measured by school and/or work attendance records and client self-report.

Client Discharge: 

Discharge Criteria

The determination to discharge an EA from MST-EA is based upon evidence of intervention effectiveness as evaluated from multiple perspectives (e.g. EA, social network members, school, probation officer) indicating that:

• a majority of the Overarching Goals for the case have been met and sustained;
• the EA has few significant behavioral health and justice-related problems;
• the EA can effectively manage any recurring problems and functions reasonably well for at least 3 to 4 weeks;
• the EA is making reasonable educational/vocational efforts;
• the EA is involved with prosocial peers and is not involved with, or is minimally involved with problem peers; and
• the therapist and supervisor feel the EA has the knowledge, skills, resources, and support needed to handle subsequent problems.

Discharge from MST-EA may also occur when few of the Overarching Goals have been met, but despite consistent and repeated efforts by the therapist and supervisor to overcome the barriers to further success, the treatment has reached a point of diminishing returns for the additional time invested.