Under the Children’s Mental Health Initiative of 1984, the Substance Abuse and Mental Health Services Administration, SAMHSA, developed a federal program to promote and support a systems of care philosophy. This was the first federally organized effort to provide funding and help states design systems of care to deal with children’s mental health needs. Studies are beginning to verify their success with children with mental health disabilities, notes SAMHSA
Definition
A system of care is not an actual program for treating children with mental health disorders. It is a philosophy describing how treatment should be delivered. Grounded in the concept that mental health care for children must be implemented across all the systems that affect children, a system of care is a network of supports to address emotional, behavioral, physical, social and mental health needs. The goal is to keep children and youth in their homes while improving their mental health and building skills for the future.
Philosophy
Systems of care follow a specific set of principles. They must be youth-guided, family-driven, build upon strengths, individualized and community-based. An important guideline is listening to, and respecting the opinions of, the child or youth with a disability. Family-driven means that the family makes the decisions. With information from health professionals, the family sets goals, chooses treatments and helps to implement the program. The treatment plan should use strengths to remediate weaknesses. Everyone who has a role in the child’s life becomes a team member, working together in a coordinated effort so that treatment is consistently implemented at home, in school and throughout the community. For this reason, systems of care are also known as community-based mental health services.
Practice
So how is the philosophy of “systems of care” put into practice? Through a method known as wraparound. Like systems of care, wraparound is not a specific practice, it is a structured, team process focused on one individual’s mental health needs. The team “wraps” the child in a supportive environment by creating a treatment plan and then implementing supports. Wraparound is a holistic approach that considers the needs of caregivers and siblings, and addresses all areas of the child’s life.
Support
Support for children with mental health disorders—and entry into the system of care—begins when a parent or caregiver seeks help for behavioral, emotional, academic or social issues that interfere with the child’s ability to function. You'll need to see a mental health professional, but if you don't know one, you may first talk to a family physician or seek referrals from a teacher, friend or mental health organization, such as a local chapter of the Federation of Families for Children’s Mental Health. After the mental health professional determines a diagnosis, he writes a prescription for wraparound, works with the parents to assemble the team, and then the team meets to begin planning community-based treatment.
Considerations
Even though funding is supposed to be available to ensure that families have the opportunity to choose an effective treatment program, reality often proves otherwise. One member of the team should be a case worker who is familiar with various funding sources.
