Considerations in System of Care Expansion: Expanding Early Childhood Systems of Care

Efforts to develop SOC's through SAMHSA’s Comprehensive Community Mental Health Services for Children and Their Families Program (known as the Children’s Mental Health Initiative – CMHI) have evolved over time. Initially, the focus was primarily on school-age and older children. The language of the authorizing legislation for this program does not preclude serving young children and their families. However, there were perceived barriers, such as the requirement of a diagnosis to be eligible for services when the early childhood field hadn’t yet universally accepted the practice of diagnosing young children. Further, the individualized, Wraparound approach to service/care planning and delivery was not seen as applicable to young children and their families.

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Effective Strategies for Expanding the System of Care Approach
This report presents the findings from a study on effective strategies for expanding the system of care approach that was undertaken as part of the national evaluation of the federal Comprehensive Community Mental Health Services for Children and Their Families Program. The study and report benefitted from the input and assistance of many people. The directors of children’s mental health in the nine states that participated in the study not only allowed themselves to be interviewed, but also enlisted others to be part of the study. In total, 52 individuals were interviewed, and the authors are most appreciative of their time and contributions.

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Effective Strategies Checklist – Children and Youth with Developmental Disorders and Challenging Behaviors
Children and youth who have intellectual disabilities or developmental disorders are at elevated risk for co-occurring psychiatric or behavioral problems. These young people pose a serious challenge for administrators, program directors and clinicians, especially when they present with aggressive or disruptive behaviors. When appropriate community services have not been organized, these youth can be among the most difficult and costly to serve. Across the country, their families report relentless stress, partly because it is very difficult to obtain the help they need. This paper provides resources and strategies that have improved outcomes and lowered costs, while diminishing risk for institutionalized placements, referrals to juvenile justice and child welfare.

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