National Survey of State Children’s Mental Health Directors: Current Status and Future Directions

Abstract

State agencies play a critical role in addressing the mental health needs of children and youth. Significant changes underway throughout the nation at the federal and state levels have led to questions about the role of state children's mental health (CMH) agencies and the effects of these changes on children's services. The purpose of this study was to examine the current status of state offices for CMH with regard to structure and responsibilities and to identify what state CMH directors express as opportunities and challenges for CMH at the state level. CMH directors or their representatives from 46 states, 1 US territory, and D.C. completed an online survey developed to address the specific aims of this study. Findings highlight the importance of a strong state structure to support CMH and opportunities for reform and system change, particularly related to the Affordable Care Act and expansion of Systems of Care.

State-Community System of Care Development: an Exploratory Longitudinal Review

“…44 . Possible explanations for this study's results include the complexity of the implementation process, 44,47 effectiveness of planned strategies, respondents' perspectives and knowledge and the study's methodology. Some planned SOC activities may not have worked or may not have been well implemented.…”

“…4,46 Further, periodic evaluation of the child mental health system infrastructure, policy development, and outcomes provides information needed for quality improvement initiatives. 43,47 The use of SOC value-based instruments, such as the SOCIS, combined with qualitative information, can provide valuable information to focus and inform strategic planning, technical assistance, and to support conditions necessary for accessible, effective child behavioral health services. To sustain SOC implementation and development, the inherent complexities of the 26 implementation process and of evaluation resources warrant additional research.…”

Behavioral Health Services Outcomes That Matter Most to Caregivers of Children, Youth, and Young Adults with Mental Health Needs

“…This belief may be due to limited investment in reducing this stigma and understanding the caregiver experience. Though public mental health administrators acknowledge the need for efforts to reduce stigma [39] and evidence suggests growing stigma around mental illness [40], compared to public expenditures and activities for behavioral health services and interventions, public activities to reduce mental health stigma are dwarfed. In the last ten years, less than half of all states reported coordinated efforts or initiatives aimed at reducing mental health discrimination [41].…”

Psychology and child protection: Promoting widespread improvement in practice.

“…These include limited state Medicaid budgets, low reimbursement rates dissuading mental health professionals from taking Medicaid cases, bureaucratic obstacles impeding reimbursement, and limitations on which mental health services and which providers Medicaid will cover (Cross, 2010; Field, 2004; Smith et al, 2016). Apart from Medicaid, financing for public child mental health services is often a stepchild to adult programs and other children’s service programs, and needs greater support and advocacy within state governments (Hernandez et al, 2017). Lack of resources was also a key reason why a Minnesota effort at mandatory reporting of exposure to domestic violence foundered (Edleson et al, 2006).…”