Annual Report to Congress on the Evaluation of the Comprehensive Community Mental Health Services Program for Children and Their Families

Introduction

In October 1993, four grantees received the first cycle of funding under the Comprehensive Community Mental Health Services for Children and Their Families Program. These include the East Baltimore Mental Health Partnership in Maryland, the Stark County Family Council and the Southern Consortium for Children in Ohio, the Village Project in South Carolina, and Families First (ACCESS Vermont) in Vermont.

As discussed in chapter II, the CMHS grantees have generally expanded or strengthened existing networks of services, instead of building service systems from scratch. In practice, this means that even the newest grantees have brought considerable experience to the task of improving systems of care for children and adolescents with serious emotional disturbance and their families. Nevertheless, as with any program that gradually expands its scope, the first funded programs have played a pioneering role, testing assumptions about what can be accomplished and contributing valuable lessons that have been incorporated into subsequent grant cycles.

The pioneering role of initial grantees is particularly marked in initiatives such as this one, in which new partnerships and data systems are required to meld previously fragmented services into a more coherent and responsive system. In an effort as complex and ambitious as strengthening systems of care, an additional year or two of data on populations and outcomes becomes a significant demarcation between older and newer grantees. Although these distinctions will fade over time, at this juncture, the original grantees offer a wealth of information about the process of strengthening systems of care that is unique among the pool of grantees.

The Graduating Sites

This summary describes the key features and outcomes of five systems of care supported by the four grantees that received funding in 1993. These include:

East Baltimore Mental Health Partnership, Maryland – a partnership among public agencies, family organizations, community-based organizations, and Johns Hopkins Hospital that serves children under the age of 18 who have a serious emotional disorder and who need services from two or more agencies.
Stark County Family Council, Ohio – a partnership among over 200 organizations that work collaboratively to improve services to children and families living in Stark County by coordinating activities, supporting families, and working to keep children within the community.
Southern Consortium for Children, Ohio – an organization that serves children and families in 10 predominantly rural and impoverished counties in Ohio, including four counties that are part of Appalachia, by securing grant funds, contracting for services, and sponsoring training and partnership-building activities.
The Village Project, South Carolina – a partnership among child-serving agencies named after the African proverb, "It takes a village to raise a child," which seeks to provide comprehensive and seamless services for children and families in the Charleston community.
Families First (ACCESS Vermont), Vermont – a statewide initiative designed to support and preserve families of children experiencing severe emotional disturbance by ensuring access to mental health and other community-based services.

Content and Scope of This Summary

Consistent with the program’s intent, each grantee approached the expansion of its system of care in slightly different ways, responding to conditions unique to each community. This summary highlights similarities and differences in their approaches, concentrating on four main categories of information:

The development of key elements of the systems of care
Characteristics of the children and adolescents with serious emotional disturbance and their families served by each system of care
Behavioral and functional outcomes
Service utilization and satisfaction outcomes

It should be noted that the five graduating sites are linked mainly by the timing of their grants, rather than by any particular similarity of approach to systems of care, target populations, or other characteristics. While each site pursued the philosophical tenets and guiding principles of systems of care, the linkage among them is in effect an accident of "birth" in the funding process. Therefore, this summary does not purport to compare the five systems of care, populations, or outcomes in the more rigorous statistical sense of comparisons among programs. This summary is instead a descriptive snapshot of the different paths that the original grantees have taken—paths that will both overlap with and diverge from those of the other grantees that followed them, as each system of care shapes itself to match the unique needs of the children, adolescents, and families it serves.

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