Defining the system of care concept and philosophy: To update or not to update? (original) (raw)
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Components of a System of Care: What Does the Research Say?
This document presents a review of recent research literature on eight components in a system of care for children with serious emotional disturbances. It is intended to be a guide and source of information to communities for building systems of care. Components include: residential services (psychiatric hospitals and residential treatment centers), outpatient services (psychotherapy), day treatment services, family preservation services, therapeutic foster care, crisis and emergency services, case management/individualized care, and family support services. The review of each component consists of definitions, summaries of outcome and empirically based efficacy studies, cost-effectiveness data, and (for most components) research needs. Generally, only studies published since 1988 were included. (Each chapter contains references.) (JDD)
2009
Examining the research base supporting culturally competent children's mental health services. (Making children's mental health services successful series, FMHI pub. no. 240-1
Impact of a System of Care on a Community's Children's Social Services System
Journal of Child and Family Studies, 2005
We examined the impact that the Dawn Project system of care had on children's services in Marion County, Indiana. A series of semi-structured interviews were conducted in order to gain a broad understanding of stakeholder perspectives related to how system-level and other community leaders viewed system of care influences. Qualitative analyses uncovered several common themes including positive impact at the community level, challenges to implementation, and feelings of ambivalence related to program impact. Results were generally positive and suggested that most respondents saw core system of care principles beginning to emerge within the community related to the establishment of the care system. In addition, challenges to implementing the system of care also were uncovered, including some underlying resistance to system-level changes. Implications from our study highlight the importance of continuously working to enhance strengths and collaboration among systems, integrate and coordinate across systems and services, and authentically involve families at all levels.
Levels of System of Care Implementation: A National Benchmark Study
The Journal of Behavioral Health Services & Research, 2011
The results of a survey to measure the implementation of the systems of care (SOC) approach in a nationally representative sample of counties are presented. The results from 910 informants within 225 counties reveal a moderate level of implementation of SOC factors, with the level of poverty and population size influencing implementation. Furthermore, mental health informants generally tended to rate the implementation of systems of care greater than administrators associated with the school system, other family serving agency personnel or family members. Family members and school personnel tended to rate the implementation lowest, while staff from the other child serving agencies tended to rate the implementation closer to mental health administrators. A quarter of the counties (26%) surveyed rated themselves as having adequate levels of implementation on 11 or more of the 14 factors, while 75% rated themselves as having adequate levels of implementation on six or more of the 14 factors measured. Implications for federal policies regarding systems of care implementation are discussed. Levels of System of Care Implementation Since the early 1980s, when leaders in the field of children's mental health, including policy makers, practitioners, researchers, and advocates, began to make systems of care for children with serious emotional disturbances a national priority, much attention and interest have been paid to
Toolkit for Expanding the System of Care Approach
The system of care approach was introduced in response to the many systemic problems in serving children, youth, and young adults with mental health challenges and their families. Since 1993, the Substance Abuse and Mental Health Services Administration (SAMHSA) has provided resources to states, communities, tribes, and territories to implement systems of care. After extensive evaluation documented the effectiveness of systems of care, SAMHSA determined that the approach was ready for widespread adoption and launched a system of care expansion initiative in 2011. To support expansion efforts, a number of resources and tools have been developed to guide jurisdictions at each stage of the process. All of these are included in this toolkit so that they will be easily accessible together and organized in sequence. A strategic framework for system of care expansion is presented, with an accompanying logic model to depict the process. Detailed guides are included that provide direction fo...
Evaluating systems of care: Missing links in children's mental health research
Journal of Community Psychology, 2004
Systems of care (SOCs) have been developed throughout the country to meet the needs of children with severe emotional disturbances (SED) and their families. In these SOCs, multiple agencies and disciplines are expected to work together with informal community supports to address families' needs . A review of the literature on the impact of SOCs suggests: (a) communities' service delivery systems change; and (b) children experience modest improvements in symptomatology and functioning. At the same time, little is known about (a) which components of the SOC approach, at what levels, are necessary to impact child and family outcomes; (b) the degree to which SOCs affect other family members, beyond the target child; and (c) the impact of community contexts and supports in SOCs. Future research should improve measurement of key SOC constructs, examine the relation between specific levels of implementation and outcomes for the entire family, and investigate the impact of broader community systems and supports on families within SOCs.
The Journal of Behavioral Health Services & Research, 2011
The children' s system of care framework has been extensively implemented in the U.S. Since its inception in 1993, the Comprehensive Community Mental Health Services for Children and Their Families Program has invested in excess of $1 billion supporting the development of systems of care in 164 grantee sites across the country. Despite these efforts to implement children' s systems of care nationally, little is known about the extent to which the principles and values actually have been put into practice outside of the funded grantee sites. This paper describes the development of the Systems of Care Implementation Survey, a measure designed specifically for the first ever study assessing the level of implementation of factors contributing to effective children' s systems of care in a nationally representative sample of counties throughout the U.S.