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Children stand to lose if the federal government follows through on threats to cut funding for critical safety-net programs that have long supported families and communities. Although cuts directly targeting children's mental health are a great concern, cuts to policies that support health, housing, education, and family income are equally disturbing. These less publicized proposed cuts affect children indirectly, but they have direct effects on their families and communities. The importance of these services is supported by an extensive body of social learning research that promotes collective efficacy-neighbors positively influencing each other-shown to have positive long-term effects on children's development and adult outcomes. In this article, the authors describe two federal programs that by virtue of their impact on families and communities are likely to promote collective efficacy and positively affect children's mental health; both programs are facing severe cutbacks. They suggest that states adopt a cross-system approach to promote policies and programs in general medical health, mental health, housing, education, welfare and social services, and juvenile justice systems as a viable strategy to strengthen families and communities and promote collective efficacy. The overall goal is to advance a comprehensive national mental health policy for children that enhances collaboration across systems and strengthens families and communities, which is especially critical for children living in marginalized communities. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented which focuses on the children's mental health services, healthcare changes such as access to health insurance and inadequacies in mental health system.

We conducted a review of empirically based prevention programs to identify prevalence and types of family support services within these programs. A total of 238 articles published between 1990 and 2011 that included a family support component were identified; 37 met criteria for inclusion. Following the Institute of Medicine's typology, prevention programs were categorized as universal, selective, or indicated; programs containing more than one prevention level were characterized as multi-level. Family support types included those led by a mental health professional, led by a peer, or team-led. Among the 37 prevention programs reviewed, 27% ( n = 10) were universal, 41% ( n = 15) were selective, 16% ( n = 6) were indicated, and 16% ( n = 6) were multi-level. The predominant model of family support was professionally led (95%, n = 35). Two ( n = 5%) provided team-led services. None were purely peer-led. In terms of content of family support services, all (100%, n = 37) provided instruction/skill build. Information and education was provided by 70% ( n = 26), followed by emotional support ( n = 11, 30%) and instrumental or concrete assistance ( n = 11, 30%). Only 14% ( n = 5) provided assistance with advocacy. The distribution of models and content of services in prevention studies differ from family support within treatment studies. As family support is likely to be an enduring component of the child and family mental health service continuum, comparative effectiveness studies are needed to inform future development. [ABSTRACT FROM AUTHOR]

The article comments on the themes of research papers related to children mental health services in the U.S. discussed at the Vanderbilt Conference in September 2009 in Nashville, Tennessee. The main theme of the paper was to look for a public health approach that required tracking and screening the population health. Another theme included the infrastructure development for retaining specialists in the mental health work force. Other theme focused on the economics of mental health services provision.

This article examines out-of-home placements for youth with mental health problems in community-based systems of care. Longitudinal data come from the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program. One third of youth residing at home when they enrolled in the system of care were placed out of home during the 2-year follow-up period. As expected, youth who were placed out of home displayed more problems, fewer strengths, and more risk factors than youth who remained at home. However, results suggested few differences between youth placed in foster care and those placed in more restrictive settings. In addition, there was increased placement instability for Hispanic and older youth. Findings suggest that out-of-home placements remain a common component in systems of care. This suggests the immediate need for additional work on effectiveness of these settings for youth within systems of care. [ABSTRACT FROM AUTHOR]

Background Children involved with child welfare systems are at high risk for emotional and behavioral problems. Many children with identified mental health problems do not receive care, especially ethnic/minority children. Objective To examine how patterns of specialty mental health service use among children involved with child welfare vary as a function of the degree of coordination between local child welfare and mental health agencies. Design Specialty mental health service use for 1 year after contact with child welfare was examined in a nationally representative cohort of children aged 2 to 14 years. Predictors of service use were modeled at the child/family and agency/county levels. Child- and agency-level data were collected between October 15, 1999, and April 30, 2001. Setting Ninety-seven US counties. Participants A total of 2823 child welfare cases (multiple informants) from the National Survey of Child and Adolescent Well-being and agency-level key informants from the participating counties. Main Outcome Measures Specialty mental health service use during the year after contact with the child welfare system. Results Only 28.3% of children received specialty mental health services during the year, although 42.4% had clinical-level Child Behavior Checklist scores. Out-of-home placement, age, and race/ethnicity were strong predictors of service use rates, even after controlling for Child Behavior Checklist scores. Increased coordination between local child welfare and mental health agencies was associated with stronger relationships between Child Behavior Checklist scores and service use and decreased differences in rates of service use between white and African American children. Conclusions Younger children and those remaining in their homes could benefit from increased specialty mental health services. They have disproportionately low rates of service use, despite high levels of need. Increases in interagency coordination may lead to more efficient allocation of service resources to children with the greatest need and to decreased racial/ethnic disparities. [ABSTRACT FROM AUTHOR]

This article compares mental health service need and use among three groups of children: those with a history of foster care placement, those in contact with departments of social services but never in placement, and those from impoverished families who have not been in contact with social services. Data come from a longitudinal epidemiologic study of mental health problems and service use. All three groups show very high rates of mental health problems, but children in foster care or in contact with social services are significantly more likely than children living in poverty to receive mental health services. [ABSTRACT FROM AUTHOR]

Comments on the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program. Sustainability of the systems of care; Role of families in research; Benefits of the system of care to children and families.

Presents the challenges faced by child mental health services research in the United States. Research priorities relevant to mental health services for adolescents; Service systems interventions; Service components; Interferences on randomized clinical trials; Suggested criteria for research studies.

Explores the roles of human service sectors in providing mental health services for children based on data provided by the Great Smoky Mountains Study of Youth, a study of psychopathology and mental health service use among children. Rates of mental health service use; Unmet need among children with a psychiatric diagnosis and functional impairment.

Presents a study on the outcomes of mental health care for children and adolescents using the I.A. comprehensive conceptual model. Five domains of the dynamic and interactional model of outcomes; Spheres of influence on child mental health outcomes; Three dimensions of measurement in a categorical system for classifying assessments of outcomes.

This paper reports on the reliability of children's responses on the Child and Adolescent Services Assessment (CASA)—a self-report instrument for use with 8- to 18-year-olds that gathers information about services used to address mental health problems. Findings were based on interviews completed by 77 children at a one week test-retest interval. Results showed that reports of lifetime service use were as reliable as were reports of service use in the preceding three months. Children reported restrictive and intrusive services more reliably than services that were provided in their natural environment. Reliability appeared to be associated more strongly with characteristics of the type of service than with characteristics of the child. Children also could report reliably on some details about their encounters with service providers (e.g., length of stay, number of visits, and onset of service use). [ABSTRACT FROM AUTHOR]

It is extremely challenging to implement evidence-based interventions in community-based agencies with sufficient quality, fidelity, and intensity to produce desired changes in practice and outcomes. This is particularly difficult to do within the confines of existing service providers' time, personnel, and resource constraints. Over the past 15 years, Together Facing the Challenge (TFTC) has been developed, tested, and disseminated in an effort to address this set of issues to improve treatment foster care (TFC). Data from the initial randomized trial showed improved practice and outcomes in TFTC compared to usual TFC. These initial results came from study-led training and follow-up consultation. Subsequent dissemination activities suggested potential need for more intensive support for TFTC supervisors to produce more consistent and sustained implementation of the model. The current randomized trial extends this work by comparing the previously tested standard consultation versus enhanced consultation that incorporated more of a coaching approach. Initial results suggest that enhanced coaching/consultation was associated with improvements in the small- to medium-effect size range. Results are promising, but require additional work to more fully understand how and whether to enhance supports as agencies implement new evidence-based approaches. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]