Changing Patterns of State Responsibility: A Case Study of North Carolina

Use of mental health services among severely emotionally disturbed children and adolescents in San Francisco

“…These landmark commission findings have been supported by numerous reports by professionals in the field, which consistently address the need to increase services in the context of an integrated network of service agencies (Coren & McKale, 1985;Inouye, 1988;Julius, Lipton, Pettifor, & Smith, 1980;Knitzer, 1982;Rae-Grant, 1976). Some attempts at such integration have been attempted in North Carolina (Behar, 1984) and Ventura County, California (Feltman & Essex, 1989;Jordan & Hernandez, 1990).…”

Structure and change in child mental health service delivery networks

“…Many innovative approaches to developing systems of care at the community level have been tried in various parts of the country (Jordan & Hernandez, 1990;Dorwick, 1988;Behar, 1985;Heflinger et al, 1992). One ambitious effort to develop systems of care for youth with SEDs was the Robert Wood Johnson Foundation (RWJF) Mental Health Services for Youth Demonstration (Beachler, 1990).…”

Developing a community-based care system for seriously emotionally disabled children and youth

“…As the result of a lawsuit, North Carolina developed one of the first, community-based systems of care providing a full continuum of services. The new system significantly reduced the number of children and adolescents that were sent out of the region to be housed in secure settings (Behar, 1985). The concept of individualized care developed in North Carolina was carried forward in the development of the Alaska Youth Initiative (AYI) and the Ventura County Project (Alternatives to, 1988).…”

“…Case management, as a co-ordinating mechanism, can ensure appropriate and responsive treatment decisions while monitoring service delivery (Behar, 1985;Stroul & Friedman, 1986). A case manager unifies service delivery (Behar, 1984) by orchestrating the coordination of services, and attempting to ensure flexibility and responsiveness while keeping the system together (Case Management, 1986).…”

“…A willingness to cooperated combined with a clarity about roles and responsibilities is necessary. North Carolina developed the Willie M. Project providing the full range of services for the most disturbed children and youth based on the lead agency model (Behar, 1985). Without strong state and local leadership, this model can result in extreme local variability as well as competition rather than coordination and cooperation.…”