Sustaining and expanding systems of care to provide mental health services for children, youth and families across America.

The Substance Abuse and Mental Health Services Administration has been instrumental in supporting the development and implementation of systems of care to provide services to children and youth with serious mental health conditions and their families. Since 1993, 173 grants have been awarded to communities in all 50 states, Puerto Rico, Guam, the District of Columbia, and 21 American Indian/Alaska Native communities. The system of care principles of creating comprehensive, individualized services, family-driven and youth-guided care and cultural and linguistic competence, supported by a well-trained and competent workforce, have been successful in transforming the field of children's mental health and facilitating the integration of child-serving systems. This approach has achieved positive outcomes at the child and family, practice and system levels, and numerous articles have been published using data collected from system of care communities, demonstrating the effectiveness of this framework. This article will describe lessons learned from implementing the system of care approach, and will discuss the importance of expanding and sustaining systems of care across the country.

Family-driven care in america: more than a good idea.

OBJECTIVES: This paper will provide a history of how family-driven care has evolved in the United States. METHODS: Several examples of family-driven care including the National Policy Academy led by the Federation of Families for Children's Mental Health, the Jefferson County Kentucky's Parent Advocacy Program, and the Family Ties Resource Centers in Westchester, New York, and the 2009 American Academy of Child and Adolescent Psychiatry's Policy Statement are used to illustrate the development of family-driven care. RESULTS: In the past twenty-five years the mental health field has shifted from viewing parents as the cause of their child's issues to active participants in treatment and active participants in policy development and system reform efforts. Research shows that better outcomes are achieved when family members and youth have meaningful roles in their treatment. CONCLUSIONS: Family-driven care has advanced in the child and youth mental health system in America and next steps are needed to further develop the ability of families to become true partners in treatment planning, service and system development, enhance research as to the effectiveness of these activities and reform policies and practices to reflect needs of families.

The Building Bridges Initiative: residential and community-based providers, families, and youth coming together to improve outcomes.

The Building Bridges Initiative (BBI) provides a framework for achieving positive outcomes for youth and families served in residential and community programs. Founded on core principles, an emerging evidence base, and acknowledged best practices, the BBI emphasizes collaboration and coordination between providers, families, youth, advocates, and policymakers to achieve its aims. Examples are presented of successful state, community, and provider practice changes, and available tools and resources to support all constituencies in achieving positive outcomes.

Defining the system of care concept and philosophy: to update or not to update?

This commentary considers the task of updating the system of care concept and philosophy within its historical context, reviewing the original intent of the definition and clarifying misconceptions about its meaning. The authors identify the aspects of the concept and philosophy that should be updated based on the latest thinking, experience, and data, such as incorporating applicability to a broader range of populations, increasing the emphasis on the core values, specifying desired outcomes, and adding accountability as a critical element. An updated definition and values and principles are proposed, and the importance of always presenting the definition along with the accompanying specification of the philosophy is emphasized in order to increase its utility in assisting the field to move from theory to practice.