According to a report by the Surgeon General, many children have mental health problems that interfere with normal development and functioning. In the United States, one in ten children and adolescents suffer from mental illness severe enough to cause some level of impairment in functioning at home, in school, or in the community. Lack of parity for mental health services is a problem for all insured individuals, including children. Early intervention is crucial for all children with mental health needs.
Research has shown that behavioral and emotional problems are more prevalent among poor children than non-poor children. This may be due to multiple policy and practice issues, including access to services, lack of health insurance, mental health system capacity, misdiagnosis, and parents’ own mental health issues. Providing mental health services can play a critical role in serving children and families who receive multiple types of assistance, including child welfare, welfare, and juvenile justice services.
There are a number of federal and state activities under way to address the needs of children with mental health problems, particularly in the context of more comprehensive, community-based services for children and families. This Resources highlights those activities as well as those of other organizations.
American Academy of Child and Adolescent Psychiatry, 202/966-7300 at http://www.aacap.org/.
American Psychological Association, Children, Youth, and Families Office, 202/336-5500 at http://www.apa.org/pi/cyf/homepage.html.
American Public Human Services Association, Jennifer Grayson (Children and Family Services department) or Kim Johnson (Health Policy division), 202/682-0100 at http://www.aphsa.org.
Bazelon Center for Mental Health Law, Chris Koyanagi, 202/467-5730 at http://www.bazelon.org/.
Children’s Defense Fund, 202/628-8787 at http://www.childrensdefense.org.
Child Welfare League of America, American Association of Psychiatric Services for Children Child Mental Health Division, Steve Hornberger, 202/639-4918 or shornberger@cwla.org at http://www.cwla.org/programs/mentalhealth/.
Federation of Families for Children’s Mental Health, Barbara Huff, 703/684-7710 at http://www.ffcmh.org/.
Georgetown National Technical Assistance Center for Children’s Mental Health, Maria Woolverton, 202/687-8635 or woolvertonm@georgetown.edu at http://gucdc.georgetown.edu/index.html.
National Association of State Mental Health Program Directors, Children, Youth, and Families Division, Roy Praschil, 703/739-9333, ext. 20 at http://www.nasmhpd.org/childdiv.htm.
National Mental Health Association, Children and Families Advocacy Division, 703/684-7722 at http://www.nmha.org/children/index.cfm.
Research and Training Center for Children’s Mental Health at http://rtckids.fmhi.usf.edu/rtcnew.htm.
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, Judith Katz-Leavy, 202/443-0000 at http://www.samhsa.gov/centers/cmhs/cmhs.html.
Bazelon Center for Mental Health Law, Covering Intensive Community-Based Child Mental Health Services Under Medicaid. (Washington, D.C.: April 2001) at http://store.bazelon.org/skuCM4.html.
Center for Effective Collaboration and Practice, Systems of Care: Promising Practices in Children’s Mental Health. (Washington, D.C.: 2001) at http://cecp.air.org/promisingpractices/Default.htm.
Howell, Embry M., Jeffrey A. Buck, and Judith L. Teich, “Mental Health Benefits Under SCHIP.” (Bethesda, Maryland: Health Affairs, vol. 19, no 6, November/December 2000) at http://www.healthaffairs.org.
Howell, Embry, Sara Roschwalb, and Miki Satake, Mental Health and Substance Abuse Services under the State Children’s Health Insurance Program: Designing Benefits and Estimating Costs. (Rockville, Maryland: Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, October 2000) at http://www.mentalhealth.org/publications/allpubs/SMA01-3473/SMA01-3473.pdf.
Knitzer, Jane, Using Mental Health Strategies to Move the Early Childhood Agenda and Promote School Readiness. (New York, New York, National Center for Children in Poverty: September 2000) at http://cpmcnet.columbia.edu/dept/nccp/SPMenHlth.pdf.
Office of Juvenile Justice and Delinquency Prevention, “Youth with Mental Health Disorders: Issues and Emerging Responses.” (Washington, D.C.: Juvenile Justice, vol. VII, no. 1, U.S. Department of Justice, April 2000) at http://www.ncjrs.org/html/ojjdp/jjjnl_2000_4/contents.html.
Surgeon General of the United States, Report of the Surgeon General’s Conference on Children’s Mental Health: A National Action Agenda. (Washington, D.C.: U.S. Department of Health and Human Services, Office of the Surgeon General, 2001) at http://www.surgeongeneral.gov/cmh/cmhreport.pdf.
Stroul, Beth A., Sheila A. Pires, Mary I. Armstrong, and Judith C. Meyers, “The Impact of Managed Care on Mental Health Services for Children and Their Families.” (Los Altos, California: The David and Lucile Packard Foundation, The Future of Children, vol. 8, no. 2, Spring 1998) at http://www.futureofchildren.org/mhc/index.htm.
Wishmann, Amy, Donald Kates, and Roxane Kaufmann, Funding Early Childhood Mental Health Services and Supports. (Washington, D.C.: Georgetown University Child Development Center, March 2001) at http://gucdc.georgetown.edu/fundingpub.html.
Woolverton, Maria, Jan McCarthy, Sara Schibanoff, and Rhonda Schutzinger, Welfare Reform: Exploring Opportunities for Addressing Children's Mental Health and Child Welfare Issues. (Washington, D.C.: Georgetown National Technical Assistance Center for Children’s Mental Health, 2000) at http://gucdc.georgetown.edu/wfpub.html.
The Tennessee Department of Human Services implemented the Family Services Counseling Program in February 2000. The Department contracted with the University of Tennessee for ten counseling agencies and hired over 100 masters-level therapists to work with families to identify and address issues such as learning disabilities, mental health, substance abuse, domestic violence, and children’s behavioral health problems. During an application or recertification process for TANF benefits, an applicant is told about the services and may receive a referral. A therapist will work with the family to resolve the issues that are interfering with their schooling or ability to find or maintain employment. The focus is on how the child’s behavioral problems are impacting the family. The counselor usually meets only with the parent(s), and occasionally works with the family as a whole. The counselors also help the parents advocate for their children in the schools. Certain parenting activities such as taking a child to counseling appointments and meeting with school officials can count as TANF “work activities”. Since the program’s inception, over 11,000 referrals have been processed. Contact Holly Cook at 615/313-5027 for more information.
In Washington, the Department of Social and Health Services and the Department of Health partner to deliver the Children with Special Needs Initiative, a program providing in-home nursing evaluations of children with special needs of parents in the Work First program (Washington’s TANF program). Case managers make referrals to public health nurses that assess the child’s special medical, developmental or behavioral needs for the impact on the parent’s ability to seek and maintain a job. The nurses report back to the caseworkers or social workers on the family’s needs and situation, including any need for specialized child care, frequent trips to therapy, among other things. The recipients may also be referred to other appropriate resources. For more information, please contact Allen Shanafelt at shanaad@dshs.wa.gov.
Fifty percent of the cases in Alabama’s JOBS Program (the state’s TANF program) are child-only cases. The Department of Human Resources piloted a program to offer counseling to those children at risk of becoming part of the foster care system. The program provides a number of services to child-only cases in kinship care, including counseling for those who need it. Children may be referred to counseling by welfare or child welfare caseworkers. The program has expanded to include several larger counties in the state. Contact Debby Wood, Director, Office of JOBS Program Operations, Family Assistance Division, at 334/242-8153.
The Wraparound Milwaukee program in Milwaukee, Wisconsin, takes an integrated, multi-service approach to meeting the needs of youth and their families. Each youth receives care tailored to their specific needs. Particularly important are the program’s strength-based approach to children and families; family involvement in the treatment process; needs-based service planning and delivery; individualized service plans; and outcome-focused approach. Outcomes for youth participating in Wraparound Milwaukee have included reduced recidivism in the juvenile justice system; significant improvement in school attendance; and better functioning at home and in the community based on nationally normed instruments. The Children’s Mental Health Services Division for Milwaukee
County delivers the program. Contact Bruce Kamradt, Director, Wraparound Milwaukee, for more information at 414/257-7639.
A number of states, including Idaho, Maryland, Nebraska, Minnesota, and North Dakota, count parenting activities that support the mental health or behavioral needs of children as allowable TANF work activities. These activities may include meeting with teachers, taking children to therapy appointments, and attending classes with children. Numerous states, including Idaho, Kentucky, Maryland, Nebraska, North Carolina, North Dakota, Arizona, and Minnesota, give counseling referrals to children, parents, or family units dealing with a child’s mental illness or behavioral problem.
WIN Staff Contact: Kelley O’Dell 202/628-5790 or kodell@financeproject.org.
The Welfare Information Network is supported by grants from the Annie E. Casey Foundation, the Charles Stewart Mott Foundation, the David and Lucile Packard Foundation, the Edna McConnell Clark Foundation, the Administration for Children and Families, U.S. Department of Health and Human Services, and the U.S. Department of Labor.
Practitioner Tools
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to include tools that can assist front line practitioners better serve their welfare and welfare-to-work clients. If you know of tools (assessment instruments, case management guidelines, planning templates, counseling resources, etc.) please email welfinfo@welfareinfo.org
