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Transforming Childrens Mental Healthcare in America
Systems of Care

Child, Adolescent and Family Branch

Background

The Child, Adolescent and Family Branch of the Federal Center for Mental Health Services promotes and ensures that the mental health needs of children and their families are met through home and community-based systems of care.

Systems of care are developed on the premise that the mental health needs of children, adolescents, and their families can best be met within their home, school, and community environments. The federal programs that are administered by the Branch are developed around the principles of cultural competence, child-centered, family-driven services that revolve around the strengths of the child or adolescent being served.  At the heart of system of care programs is interagency collaboration at the community level.

Areas of Activity

Comprehensive Community Mental Health Services Program for Children and Their Families 

The Comprehensive Community Mental Health Services Program for Children and Their Families (Children’s Services Program) provides grants and cooperative agreements to States, communities, territories, Indian tribes, and tribal organizations to improve and expand their systems of care to meet the needs of an estimated 4.5–6.3 million children with serious emotional disturbances and their families. The program was first authorized in fiscal year 1992 by sections 561-565 of the Public Health Service Act, as amended. The grant program has funded a total of 92 grantees across the country. There are currently 61 active system of care communities.

The Children’s Services Program promotes the development of service delivery systems through a system of care approach. This model is based on a philosophy that includes four elements: 1) the mental health service systems are driven by the needs and preferences of the child and family addressed through a strength-based approach; 2) the focus and management of services occur within a multi-agency collaborative environment and are grounded in a strong community base; 3) the services offered, the agencies participating, and the programs generated are responsive to the cultural context and characteristics of the populations served; and 4) families are partners in planning and implementing the system of care. Communities are given flexibility in how they organize their system of care approach to meet the needs of their children and families.

System of care communities collaborate with a national multi-site evaluation, are provided training and technical assistance on systems of care principles and processes, and develop social marketing/public education outreach programs.

System of care communities participate in a 2- to 3-day evaluation community visit every 18 months to assess and monitor the overall progress of systems of care development in their community. Additionally, a Federal review team (including the Federal Project Officer) conducts a community site visit, usually in years two and four of the cooperative agreement, to gauge progress toward achieving the goals as set forth in the application.

Statewide Family Networks

Forty-two statewide Family Network grantees provide information, referral, and support to families of children and youth with or at risk of experiencing serious emotional disturbances. These grantees also participate in the development of policies, programs, and quality assurance activities related to the mental health of children and adolescents with serious emotional disturbances and their families. This grant program is designed to increase the capacity of statewide family network grantees and to strengthen coalitions among family members, policymakers, and service providers. The essence of knowledge application is achieving change with the recognition that family members are the best and most effective change agents. Technical assistance is provided to the grantees through the United Advocates for Children of California.

Child and Adolescent Mental Health and Substance Abuse State Infrastructure Grants (CA-SIG)

The Child and Adolescent Mental Health and Substance Abuse State Infrastructure Grants (CA-SIG) strengthen the capacity of States, territories, and Native American tribal governments to develop and sustain substance abuse and mental health services including early intervention, treatment, and/or continuing services and supports at the local level of children, adolescents and youth in transition (ages 0-24), who have a serious emotional disturbance, substance abuse disorder, and/or co-occurring disorders, and their families. Applicants are expected to use grant funds to build the infrastructure necessary to promote, support, and sustain local service and treatment intervention capabilities for the target population across service delivery systems.  The program is intended to provide sufficient flexibility and scope to enable States to determine whether they will focus on the entire target population or demographic/geographic subsets of the population.

Circles of Care

In collaboration with the Indian Health Service and the National Institute of Mental Health, seven 3-year grants were awarded in 2001 to plan, design, and assess the feasibility of implementing a culturally appropriate mental health service model for American Indian/Alaska Native children with serious emotional disturbances and their families. This program is intended to support tribes and urban Indian organizations in developing service delivery models that match the treatment methods selected by American Indians/Alaska Natives for their own children. The program is also intended to support the development of measures and processes that will be useful to tribal and urban Indian organizations in evaluating their service models.

Partnerships for Youth Transition

The transition from adolescence to adulthood is difficult for many young people. Youth with serious emotional disturbances and serious mental illnesses are particularly at high risk during the transition to adulthood. These young people have the highest dropout rate among all youth with a disability, have more confrontations with the juvenile justice system, often fail to live independently—resulting in homelessness—and are more prone to unplanned pregnancy than youth in other disability groups.

Often, system-generated plans for transition services under the Individuals with Disabilities Education Act are weak and not followed effectively, or children’s services are often withdrawn abruptly, based on age, not the need for services. In addition, the criteria for service eligibility are inconsistent, and youth may not be eligible for services and supports in another location. Adequate assessment is frequently not conducted.

Five 4-year cooperative agreements were awarded in 2003 to plan, design, and implement youth transition programs for children with serious emotional disturbances and their families.

The Office of Special Education, U.S. Department of Education is a contributor to this program. Technical assistance is provided by the University of South Florida, Department of Child and Family Studies through a grant from the Jim Casey Youth Opportunities Initiative, Annie E. Casey Foundation.

Child, Adolescent and Family Branch
Division of Services and System Improvement
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road, Room 6-1050
Rockville, MD 20857
Phone: 240-276-1980
Fax: 240-276-1990
Web site: http://www.samhsa.gov/cmhs/cmhs.htm 
Gary M. Blau
Chief
Phone: 240-246-1921
E-mail: gary.blau@samhsa.hhs.gov 
Diane Sondheimer
Deputy Chief
Phone: 240-276-1922
E-mail: diane.sondheimer@samhsa.hhs.gov 
Lisa A. Adams
Grants Management Assistant
Phone: 240-276-1931
E-mail: leah.adams@samhsa.hhs.gov 
Kristin N. Williams
Evaluation Research Analyst
Phone: 240-276-1934 E-mail: kristin.williams@samhsa.hhs.gov
Jill Erickson
Project Officer
Phone: 240-276-1926
E-mail: jill.erickson@samhsa.hhs.gov
Michele Herman
Project Officer
Phone: 240-276-1924
E-mail: michele.herman@samhsa.hhs.gov 
Sylvia Fisher
Evaluation Director
240-276-1923
Sylvia.fisher@samhsa.hhs.gov
Lisa Rubenstein
Project Officer
Phone: 240-276-1927
E-mail: lisa.rubenstein@samhsa.hhs.gov
Susan Stromberg
Project Officer
Phone: 240-276-1929
E-mail: susan.stromberg@samhsa.hhs.gov 	
Hardy Stone
Project Officer
Phone: 240-276-1928
E-mail: hardy.stone@samhsa.hhs.gov 
Elizabeth Sweet
Project Officer
Phone: 240-276-1925
E-mail: elizabeth.sweet@samhsa.hhs.gov 

									
 
  Please direct information updates to soc@samhsa.gov with the specific location or internet address to be updated. Thank you.
Systems of Care