Unique System of Care Issues and Challenges in Serving Children Under Age 3 and their Families

Abstract

This article addresses the primary modifications necessary for system change to better meet the mental health needs of children under the age of three. The role of risk and resiliency factors in the young child, family and community and the necessity for a comprehensive community infant-family mental health system with a focus on the whole family are addressed. Barriers to care within early childhood systems of care are examined, including stigma, community referral and collaboration, diagnostic concerns during infancy, issues around family engagement, empowerment and partnership, funding of comprehensive and well coordinated infant-family services, workforce capacity and evaluation. Recommendations for implementation of system changes at the community and federal levels are proposed.

Systems of Care: New Partnerships for Community Psychology

“…Given the growing emphasis on the use of SOCs with diverse populations, several papers focus on the ways that SOCs need to modify operations and practices to address the needs of those populations. For example, the systemic issues involved in addressing the needs of youth in the juvenile justice system (Erickson 2012), young children (Finello and Paulson 2012), youth with co-occurring traumatic stress and substance use (Suarez et al 2012), and urban American Indian youth and families (West et al 2012) and older youth (Haber et al 2012) are described. Efforts growing out of the National Evaluation's System of Care Assessment (SOCA), which focuses on system change, describe the variability across federally funded sites (Brannan et al 2012) and the use of system change measures to predict individual-level change (Barksdale et al 2012).…”

“…The potential for such analyses, using data from the national evaluation, has only begun to be tapped. Of particular need is research that examines changes in children and families as a function of the quality of implementation of wraparound and work that examines the utility of wraparound for older (Haber et al 2012) and younger (Finello and Paulson 2012) youth, those involved in juvenile justice systems (Erickson 2012), and those experiencing traumatic stress and/or substance abuse (Suarez et al 2012). SOC-based work has identified gaps in system functioning and provided a springboard for policyoriented recommendations (e.g., Cook and Kilmer 2010a, b;Kilmer et al 2010a;b); however, overall, scant research has examined the broader context of SOCs (Burns et al 2006).…”

Sustaining and Expanding Systems of Care to Provide Mental Health Services for Children, Youth and Families Across America

“…Among these elements, the integrated SOC must be accessible from multiple points of entry, or through ''no wrong door.'' Systematic screenings and assessments should be focused on a multitude of issues, including but not limited to trauma exposure, substance use, violence, and child maltreatment (Finello and Poulsen 2012;Suarez et al 2012). Systems of care should not be limited to a single model or approach.…”

“…Such training should focus on how to deliver strengths-based assessments and interventions (McCammon 2012), and how to address the basic of needs of youth and families so that they may meaningfully and actively participate in treatment and function in the community . Training must also help providers effectively engage and support youth and families to take the lead in service delivery (Slaton et al 2011), and build on the relationships that youth and families already have with peers, community partners, and faith-based organizations (Finello and Poulsen 2012). Additionally, training must be supported by consistent and meaningful supervision by supervisors and managers who are supportive of, and committed to, family-driven and youth-guided services.…”

“…Several of the articles in this issue highlighted the value of treating the whole family, rather than focusing on one individual or ''patient'' as the locus of care and intervention Finello and Poulsen 2012;Haber et al 2012;Suarez et al 2012). True family-driven care is when the focus of intervention is the whole family, and where the dichotomy between adult and child mental health systems is diminished.…”