Child and Family Profiles

The best evidence that community-based mental health services are successful are the stories of the families whom these services have helped. Below are four profiles of children and adolescents with mental health problems and their families who have benefited from family-oriented systems of care. Each family is a client of a grantee site under the Comprehensive Community Mental Health Services for Children Program. For this fact sheet, the names of all people have been changed.

Larry

Without the Village Project, a grantee site that offers community-based mental health services in South Carolina, Pete and Judy may not have been able to hold their family together. Pete and Judy report that their 6-year-old son Larry had been severely sexually, physically, and emotionally abused before coming to live with them at the age of 3. His current diagnoses are post-traumatic stress disorder and a brain disorder. Larry is extremely anxious and fearful. His severe violent outbursts, night terrors, and inability to concentrate have created enormous stress on the family and in school. The family's health insurance company offered no help because Larry's condition existed before the policy began. Medicaid wasn't available because the family's income was above the poverty line.

The Village Project has provided Larry a one-on-one "shadow person" to assist him in his after-school program. That service soon will be expanded to help Larry during the school day so that he can learn to control his aggression. Judy and Pete get respite care twice a month. Judy, a research analyst and former social worker, reports that the Village Project's services are "realistic, practical, and much needed-they help lower our stress level and help Larry succeed."

Susan

Susan and her family had been in and out of therapy since she was 2 years old. It wasn't working. Aggression, noncompliance, and truancy from school became the rule rather than the exception for Susan. She was diagnosed with a serious emotional disturbance. Things began looking up when Susan turned 14, and the family began working jointly with a community mental health center and a social and rehabilitation agency in a Vermont community. Success came gradually, thanks to the intensive, family-based program that served Susan and her family for about 3 years. The team included a psychologist, a social worker, respite workers, a case manager, and the family. Susan spent the last year and a half with a therapeutic foster parent who cared for her with the help of a respite care worker.

Her family was very involved throughout her care. Weekly meetings were held with Susan, with the family, and then with Susan and her family together. Susan's mom says the keys to success have been flexibility and a team approach, with the family at the center.

Susan is now 18 and lives independently, with her family and support team close by. She earned her GED and supports herself by working 40 hours a week.

Keisha

Had it not been for the family network serving a rural area in western Kansas, Laverne says, things would have only gotten worse for her daughter and for the whole family. Although Keisha was in the third grade, she could barely read and was constantly getting into fights in school. Laverne didn't know what was wrong. She blamed herself. Keisha's teacher was frustrated and didn't know how to help. Tom, a parent in the family network, told Laverne that Keisha was entitled to an assessment. Keisha was diagnosed with attention-deficit/hyperactivity disorder. Like many children and adolescents with this disorder, she had trouble staying focused on an activity. The school psychologist explained that when Keisha experienced a problem with schoolwork she became frustrated and acted out.

Now Keisha is a fifth grader who reads at a seventh-grade level and is on the honor roll. Her individualized education program, which was designed with the help of the school psychologist, includes a daily class with a specially trained teacher who reviews Keisha's work, helps her with her assignments, and counsels her on emotional issues. Laverne gets the support she needs at Tom's weekly parent support group meetings. "This is a terrific investment. Many children like Keisha get no help, and eventually manageable problems become unmanageable," Tom explained. "Then, everyone loses. But in Keisha's case, everyone wins!"

Hector

Hector was 11 years old when he saw his brother die in a gang war in a Los Angeles barrio. Three years later Hector was on the other end of an attack, and the victim was the cousin of his brother's killer. Thanks to an enlightened and understanding judge in the juvenile justice system, Hector was referred to the county mental health center for an assessment. "It's so tough growing up in this city, with drugs and violence everywhere," his mother Carmen said. Hector was diagnosed with post-traumatic stress syndrome. Discussions with school personnel revealed that Hector was a bright boy who tried in school and wanted to do well. But he often fell apart under stress from schoolwork or the inevitable social problems that junior high school students face.

Hector's probation officer, school principal, and the head of a community mental health center joined his family in designing a program for him. Hector attends a stress management course each week at school. A home visitor meets with Carmen and her husband Carlos weekly to help with family issues. A trained respite worker spends a day each month with Hector and his five siblings so that the parents can have time alone and rest from the task of raising a large family on very low wages. "Hector is a good boy, but if it were not for the program we designed, he'd be incarcerated-at great expense to the taxpayer," his probation officer says.

For more information on systems of care, call 1.800.789.2647.

Important Messages About Children's
and Adolescents' Mental Health:

Every child's mental health is important.
Many children have mental health problems.
These problems are real and painful and can be severe.
Mental health problems can be recognized and treated.
Caring families and communities working together can help.
Information is available; call 1.800.789.2647.

For free information about children's and adolescents' mental health-including publications, references, and referrals to local and national resources and organizations-call 1.800.789.2647; (TDD) 301.443.9006; or go to mentalhealth.samhsa.gov.

CA-0018
12.98