champions for children’s mental health cyf division.pdfchampions for children’s mental health...
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Champions for Children’s Mental
Health
Challenges and Opportunities
Gary M. Blau, Ph.D., Chief, Child, Adolescent and Family Branch • Center for Mental Health Services Substance Abuse Services and Mental Health Services Administration, Rockville, MD
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T = (V + B + A) × (CQI)2
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You are never more than 6 degrees away from Kevin Bacon…
About five degrees away from a frog…
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You are never more than 2 degrees away from a mental health champion…
YOU!
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Reduce the impact of substance abuse and mental illness on America’s communities
Behavioral health is a component of service systems that:Improve health statusContain health care and other costs to society
Prevention WorksTreatment is effectivePeople recover from mental and substance use disorders
SAMHSA Mission
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Prevention of Substance Abuse and Mental Illness
Trauma and JusticeMilitary Families – Active, Guard, Reserve
and VeteranHealth ReformHousing and HomelessnessJobs and EconomyHealth Information Technology for
Behavioral Health ProvidersBehavioral Health Workforce - In Primary
and Specialty Care SettingsData, Outcomes and Quality –
Demonstrating ResultsPublic Awareness and Support
SAMHSA’sStrategic Initiatives
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Addressing child, youth and family behavioral health issues within each strategic initiative.
Demonstrating that initiative is “making a difference” and program is worth keeping, adapting, enhancing.
Do the right thing and do things right.
Key Tasks
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010
,000
20,00
030
,000
40,00
050
,000
60,00
070
,000
80,00
090
,000
100,0
00
FY1993
FY1994
FY1995
FY1996
FY1997
FY1998
FY1999
FY2000
FY2001
FY2002
FY2003
FY2004
FY2005
FY2006
FY2007
FY2008
FY2009
FY2010$0
$10
$20
$30
$40
$50
$60
$70
$80
$90
$100
$110
$120
$130
# of Children Served (total across all years)# of Children Served (annual)# of New Enrollees (annual)Congressional Allocations (in millions)Federal expenditure per Child (in thousands)
Program Funding and Children Served
Through Fiscal Year (FY) 2009: 102,000 children & youth & their families served Average # of children/youth served per year = 11,306
Average FY 2008 program cost per child/youth served = $7,830
Chi
ldre
n
Phase IPhase II
Phase IIIPhase IV
Phase VPhase VI
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System of Care Communities of the Comprehensive Community Mental Health Services for Children and Their Families Program
Funded CommunitiesDate Number
Hawaiʽi (3 communities)
New Mexico (3 areas)
Alameda County, CA
Madison County, ID
Alabama(3 counties)
Illinois(3 counties)
Champaign County, IL
KentCounty, MI
Knox County, TN
Maryland (9 counties)
Onondaga County, NY
Pennsylvania (15
counties)
Orange County, FL
Miami-Dade County, FL
2009 20
San Francisco, CA
Guam
Mississippi (statewide)
Boston, MA
Clermont County, OH
Hamilton County, OH
Albany County, NY
New London County, CT
Northern Kentucky
Montana &Crow Nation
Los Angeles County, CA
Butte County, CAPlacer County,
CA
Blackfeet Tribe, MT
Wyoming(statewide
)
Minnesota(4
counties)
Kalamazoo County, MI
InghamCounty, MI
Beaver County, PA
Allegheny County 2, PA
Monroe County, NY
Mississippi
River Deltaarea, AR
HarrisCounty,
TX
Honolulu, HI
MauryCounty,
TN
Mecklenburg County, NC
SarasotaCounty,
FL
Rhode Island 3 (statewide)
Worcester County, MA
Maine (3 counties)
Erie County, NY
Seven Generations System of Care, CA
Pascua Yaqui
Tribe, AZ
St. Joseph, MO
Minnesota(6 counties)
Yankton SiouxTribe, SD
McHenry County, IL
Iowa(10
counties)
Mississippi(3 counties)
Multnomah County, OR
Northwest Georgia
Delaware 2 (statewide)
Nassau County, NY
OrangeCounty, NY
ShelbyCounty, TN
Texas(11
counties) Texas(5
counties)
Northwest Portland Area Indian Health
Board
Yakima County, WA
Alamance County, NC
Southeastern Indiana
Oklahoma (statewide)
Baltimore City, MD
Chautauqua
County, NY
Lummi Nation
Creek Nation
Kentucky(statewide)
Vermont 3 (statewide)
2008 182005–2006 302004 42002–2003 251999–2000 221997–1998 231993–1994 22
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Anxiety about the future? Now more than ever a System of Care Approach is needed
• SOC Policy and Practice creates efficiencies
• Improved outcomes across child serving sectors
• Need to expand and make common practice
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Systems of Care Work
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Implement Authentic Family-Driven Care
Empower Youth
Create New Partnerships
Eliminate Disparities
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Increa$e Youth Involvement
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Authentic Family
Driven CareParent Support Provider Initiative
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The Quality Direction
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(n = 4,737)
Employment Status of Caregivers at Intake and 6 Months
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Five Most Frequently Taken Antidepressants, Antipsychotics,
and Psychostimulants
20%
46%39%
14%
22%26%
13%
12% 25%
11%
11%6%
10%
4%2%
31%
5%2%
Antidepressants Antipsychotics Psychostimulants
Zoloft
Endep/ Elavil**
Wellbutrin
Paxil
Prozac
Other*
* Includes Desyrel, Celexa, Effexor, Anafranil, Lexapro.** Elavil was discontinued in 2003.
Risperdal
Seroquel
Zyprexa
Abilify
OtherGeodon
Adderall
Ritalin
Concerta
DexedrineMetadate
Other
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Trends in Psychotropic Medication Use: 1999–2008
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
99 00 01 02 03 04 05 06 07 08
Antidepressants
Anxiolytics
Antimanics
Antipsychotics
Psychostimulants
Antihypertensives
Anticonvulsants
FDA Warning
Year
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0%
20%
40%
60%
80%
100%
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Suicide attempts
Depression-relatedproblems
Trends in Suicide Attempts Prior to Intake and Depression-Related
Problems
FDA Warning
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Activities in ProgressWeb Site
• NAMBHA created a Web site that will serve as a national source of information and resources about mental health disparities.
www.endmentalhealthdisparities.org
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Activities in ProgressTeleHealth
• Community TeleHealth resource guide.• Health Buddy project for Native American
veterans with PTSD. • Rural Meeting
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Next Steps and New Priorities
Community-DefinedEvidence and
Practice-Based EvidenceLGBTQI2-S
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Systems of Care Work!!
Focus on youth and families: Involving youth and families in strength-based treatment approaches works!!
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things to
remember when
doing this work…
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Be on the lookout
for new
opportunities…
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Thursday, May 6, 2010
2010 National Children’s Mental Health
Awareness Day
Revised 10/30/09
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30
Nationwide Art Action
Community Level Activities
Nationwide Art Action Symbol
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Use the buddy
system when
working on
systems
change…
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A Public Health
Approach to Children’s
Mental Health
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Celebrate the
uniqueness
of the families
you work with
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The National Building Bridges Initiative
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Highlights of BBI• National Steering Committee• Two National Summits held (2006 and 2007) (3rd
planned: June 7 – 10, 2010)• Workgroups:▫ Outcomes▫ Youth/Family Partnerships▫ Social Marketing
• Documents to support the field:▫ Joint Resolution▫ Matrix/Self Assessment Tool▫ Family & Youth Tip Sheets▫ www.buildingbridges4youth.org
• State and Local Efforts (NY, PA, GA, MA)
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BBI Products & Resources• BBI website (www.buildingbridges4youth.org): The new BBI website is
official and was launched on 1/29/10! Please visit the website and review all of the BBI documents available to support work with children, youth and families.
• BBI Self-Assessment Tool (SAT) and the SAT Glossary: Residential programs, the youth and families they serve, and their community program counterparts now have a useful tool available to assess their current activities against best practices consistent with the BBI JR Principles. ▫ The SAT: designed to be used with groups of residential and community staff,
advocates, families and youth to facilitate discussion on how program and community efforts to implement best practices can be most effectively supported.
▫ The SAT Glossary provides a definition of terms used throughout the SAT.▫ Will be available on the BBI website with additional information about how to use
the SAT.
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BBI Products & Resources• Family Tip Sheets - Short and Long Versions: The BBI Family Advisory
Network, comprised of family members and advocates who have had children in out-of-home care programs, have developed both short and long versions of the Family Tip Sheet.
• The Family Tip Sheets support family members by identifying important issues that family members might consider relative to their child’s residential experience and information they may want to explore with their residential provider.
• It is recommended that both versions be distributed to family support/advocacy organizations; residential and community programs should also provide new and existing family members with copies of both documents.
• State and county policy makers and associations may want to distribute both versions of the Family Tip Sheet to programs they oversee or to their member organizations.
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BBI Products & Resources• Youth Tip Sheets - Short and Long Versions: The BBI Youth Advisory Group has
completed both short and long versions of the Youth Tip Sheet, entitled: Your Life –Your Future: Inside Info on Residential Programs from Youth Who Have Been There. The Youth Tip Sheets offer both words of support and a framework for guiding youth to ask questions that will help them be informed partners in their own care. Both the short and long versions of the Youth Tip Sheets can also be used as part of an admission packet.
▫ The Youth Tip Sheet – Short Version is for youth who may be considering a residential program and/or those about to enter or who are already in a residential program. Ideally, a youth advocate or youth mentor would review the Youth Tip Sheet with the youth individually.
▫ The Youth Tip Sheet – Long Version will interest youth who wish to gain a more in-depth understanding of how they can ‘take charge’ of their own treatment and recovery and can be used by advocates, providers, families and policy makers to ensure that residential and community programs serving youth, and their families, are truly youth-guided.
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Got a question about how to develop a family-driven, youth-guided system of care?
Start here
www.systemsofcare.samhsa.gov
Find the
holes in the
bread and
make ‘em
work…
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Technology “R” Us
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“The possibilities are endless. The time to take action is now.”
~ Gary M. Blau ~
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So get more families &
youth involved…
We need more dads!
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Talk to your colleagues about the values and principles of systems of care…
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Yes, there will be naysayers who will say “arrgghh!!!!” to systems of care…
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But you can counteract that by documenting your success…
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And spread the word that Systems of Care work!