Future Plans for SCDMH School-Based Mental Health Program Building Mentally Healthy Communities for Children and Adolescents Roadmap for System of Care Development Author: Elizabeth V. Freeman, LISW, MSW The President’s New Freedom Commission on Mental Health discusses the disparity of the mental health services for children and adults in the United States (October 2002). The mental health system lacks coordination and delivery of services. The disparity of services and coordination of care for children and their families affects all aspects of a child’s life: school failure, family disruption, social relationships, abuse (i.e., physical, substance, emotional), crime and incarceration. Such problems are consistently increased as children and youth internalize the debilitating effects of performing poorly at school and are punished for the misbehavior that so often is a common precursor to school failure. Both academic and non-academic barriers to learning exist. Non-academic barriers are well documented in research and include a host of community, family, school, peer, and individual factors that contribute to behavior, emotional, and learning problems. These concerns must be addressed if schools are to function satisfactorily and students are to succeed in school. The national technical assistance centers (CSMHA and SMHP*) for development of school mental health has consistently reported an emphasis in the health and social services arenas on increasing linkages between schools and community service agencies. This “school-linked” agenda has added impetus for advocacy of mental health programs in schools. These programs have been developed for purposes of early intervention, crisis intervention and prevention, treatment and promotion of positive social and emotional development of youth. A large body of research supports school-based strategies for helping children/youth/families is to provide mental health programs in schools. For many youth schools are the main arena to access mental health services. Development of mental health programs in schools must address barriers to learning and promote healthy development of children and youth. Mental health in schools must be understood as essential to addressing barriers to learning and not separate to the school’s instructional mission. This approach will ensure that schools are caring and supportive places that maximize learning and promote the well being of students, families, schools and neighborhoods. Integration of mental health programs and services in every school will ensure that all students are assured equitable opportunities to achieve educational success. The Goals and Objectives of developing a system of care model in the school-based mental health program are: 1) Provide a comprehensive early screening for all students for emotional and behavioral difficulties, 2) Comprehensive interventions that are matched to the needs of individual students, 3) Promote evidence-based practices, 4) Improve clinical outcomes, 5) Cost-share/maximize resources, 6) Promote culturally appropriate community-based interventions, 7) Promote educational programs in which parents’ play an active and continuous role, and 8) the development of community driven programs and services in schools. The overall outcome for children, youth and families is for the child/youth to remain in school, in the family home and to become a productive member of their community. The overall outcome for agencies and organizations is to decrease children/youth placements and length of stay in residential treatment centers and to divert from entering juvenile justice facilities, inpatient hospitals, and out-of-home placements (foster care and residential treatment). Strategies to meet these goals include developing a community team approach to treatment and program development. Upon entering the school mental health program students will enter an appropriate community intervention program to meet their current needs. Wrap Emergency Service Crisis Intake/Crisis/Assessment Child, Family, Clinician, Case DJJ, Family’s Choice, Family Management DDSN, Education, DSS, Preservation Other involved parties School-Based Outpatient Services Community TX Services These strategies incorporate and include the following: 1) Increasing input from all stakeholders in developing a plan of intervention for children/youth and their families, 2) Pursue state and local policy revisions and initiatives that broaden service parameters and leverage additional resources, 3) Refocus diversion and best practice strategies into mental health treatment and early intervention school programs, 4) Redefine core services in terms of processes - not billing codes, 5) Strategically shift placement resources to the local community agencies and non-profit organizations, 6) Expand initiatives within the community to provide more family preservation programs, and 7) Shift resources/physicians from clinic to community to address critical unmet needs. Conclusions: SCDMH and their partners have begun the development of coordinated systems of care for children/youth and their families. The President’s Commission on Mental Health reports the development of an array of effective strategies, services and supports will facilitate recovery for individuals suffering with mental illness. More individuals will enter recovery as more programs are developed that are tailored to meet their individual needs. SC DMH is committed to the development of a system of care for communities in South Carolina, and the development of evidence based treatment services within each community and in school-based mental health programs in order to afford access to services that promote recovery from emotional disturbance and ensure a quality life.
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