Workforce Development and Mental Health Transformation: A State Perspective.

The existence of a workforce crisis in behavioral health has been recognized for decades. However, workforce problems often have been viewed as too large, too complex, and too daunting for individual states to tackle. This article reviews the progress of one state in systematically strengthening its workforce as part of a federally supported effort to transform mental health services. The workforce priorities in Connecticut are identified and the specific workforce transformation projects and their impact are described. The success in sustaining these initiatives after cessation of federal support is reviewed. The authors conclude by offering five recommendations to guide comprehensive state workforce development. This work has particular salience for the many states across the nation that have identified behavioral health service and workforce needs as obstacles to comprehensive health care reform.

Commentary: the role of mental health services in preadjudicated juvenile detention centers.

The role of preadjudicated juvenile detention centers (JDCs) in treating children and adolescents with mental health needs has continued to receive national attention. Legal actions mandating improved health care services over the past decade, coupled with a national focus on detainees' mental health needs, have led to the increased presence of mental health professionals in JDCs. In this context, we must build on the current "call to action" and develop innovative blueprints for the provision of mental health services for detained youth. Although operationalizing this movement is complicated, we must be prepared to sustain its effects by developing effective communication and planning among correctional health care organizations, universities, municipalities, and other stakeholders.

Mental health care in juvenile detention facilities: a review.

Juvenile detention facilities have come under increasing legal pressure to provide mental health services to detainees, and mental health clinicians may be asked to design and implement programs in detention facilities. However, there is little consensus on what types of services should be provided, and virtually no data on the effectiveness of such services in a detention setting. The objective of this article is to provide an overview of the existing literature on mental health services in juvenile detention and to make suggestions about future research needs. Specifically, it highlights the tension surrounding the provision of mental health care in juvenile detention, presents data on the prevalence of psychiatric problems in detention settings and what types of services are currently provided, and draws on the larger child and adolescent mental health literature to suggest what types of services might be most appropriate for juvenile detention settings. We conclude that, although there are some suggestions of promising interventions that may be appropriate, much more research, specifically in detention settings, is needed to determine their effectiveness.

Graduate education and training for contemporary behavioral health practice.

Over the past decade, a new paradigm in behavioral health care has emerged. It places emphasis on cost control, evidence-based practice, patient safety, access to care, treatment relevance for diverse populations, consumerism, and quality of care. Unfortunately, graduate education and training programs have had difficulty keeping pace with the dramatic changes in the field. As a consequence, there is concern that the graduates of many of these programs are not being adequately prepared to practice in current health care systems. This article reviews the nature of recent changes in behavioral health care, the current status of graduate education programs with respect to these changes, and offers 15 recommendations for increasing the relevance of graduate education to contemporary clinical practice.