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Wraparound Milwaukee

Ages 13-17

Rating: Level 3


Wraparound Milwaukee is a system of care for children with serious emotional, behavioral, and mental health needs, and for their families. Its approach emphasizes developing services and delivering them to families who are strength based, highly individualized, and community oriented. Managed through the Child and Adolescent Services Branch of the Milwaukee County Mental Health Division in Wisconsin, Wraparound Milwaukee attempts to meet the mental heath, substance abuse, social service, and other supportive needs of the most complex youths in the Milwaukee community.

In 1994 the Milwaukee County was awarded a 5-year Federal grant from the Center of Mental Health Services to initiate a coordinated system of community-based care for families of children with severe emotional, behavioral, and mental health needs. This wraparound approach is based on an identification of the services families really need to care for a child with special needs. It identifies the personal, community, and professional resources to meet those needs, and it wraps those services around the child and family. Youths are referred to the program by probation officers or child welfare workers. The program targets children who meet the following criteria:

  • They have a current mental health problem identified through an assessment tool.
  • They are involved in two or more service systems including mental health, child welfare, or juvenile justice.
  • They have been identified for out-of-home placements in a residential treatment center.
  • They could be returned sooner from such a facility with the availability of a wraparound plan and services.

If Wraparound Milwaukee determines that enrollment is appropriate, the youths are court-ordered through the dispositional process or delinquency orders. The components include care coordination, a child and family team (CFT), a mobile crisis team, and a provider network.

The care coordinators are the cornerstones of the system. They perform strength-based assessments, assemble the CFT, conduct plan-of-care meetings, help determine needs and resources with the youth and family, assist the team in identifying services to meet those needs, arrange for community agencies to provide specific services, and monitor the implementation of the case plan. Care coordinators in Wraparound Milwaukee typically work with small caseloads (a ratio of one worker to eight families).

The CFT is a system of support that includes the family’s natural supports (such as relatives, church members, and friends) and systems people (including probation or child welfare workers). The mobile crisis is a 24-hour crisis intervention service that is available to meet the needs of youths and families when a care coordinator is unavailable. The team consists of psychologists and social workers trained in intervening in family crisis situations that might otherwise result in the removal of youths from their homes, schools, or communities. Youths participating in Wraparound Milwaukee are automatically enrolled in this crisis service, and their care plans include a crisis safety plan that the team can immediately access.


The Wraparound Milwaukee evaluation used a one-group, pretest–posttest design. The Child and Adolescent Treatment Center collected data for the 3 years immediately before youths’ enrollment in the project and the 3 years following enrollment. The center reviewed court records for delinquent youths enrolled in Wraparound. The center also administered clinical measures, including the Family Quality Improvement Questionnaires, the Child Behavior Checklist, the Youth Self-Report, and the Child and Adolescent Functional Assessment Scale, to assess youth progress and family satisfaction at intake, 6 months, 1 year, 2 years, and disenrollment.


The evaluation demonstrated significant improvements for delinquent youths. An assessment of pretest and posttest scores reveals that youths involved with wraparound services significantly improved functioning at home, at school, and in the community. In addition, the evaluation demonstrated a significant reduction in recidivism rates. In the 3 years preceding discharge from the program, 56 percent of the participants were referred for felonies, compared with 33 percent of the participants during the 3 years following discharge. Similarly, in the 3 years prior to discharge from the program, 79 percent of the participants were referred for misdemeanors, compared with 43 percent of the participants during the following 3 years. The reduction was consistent for many types of offenses (1 year following enrollment) including sex offenses (14 percent to 2 percent), property offenses (42 percent to 15 percent), assault offenses (20 percent to 5 percent), and weapons offenses (11 percent to 3 percent).

Risk Factors


  • Anti-social behavior and alienation/Delinquent beliefs/General delinquency involvement/Drug dealing
  • Cognitive and neurological deficits/Low intelligence quotient/Hyperactivity
  • Early onset of aggression and/or violence
  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use
  • Mental disorder/Mental health problem/Conduct disorder
  • Victimization and exposure to violence


  • Child victimization and maltreatment
  • Family history of the problem behavior/Parent criminality
  • Family management problems/Poor parental supervision and/or monitoring
  • Family violence
  • Maternal depression
  • Parental use of physical punishment/Harsh and/or erratic discipline practices
  • Sibling antisocial behavior


  • Identified as learning disabled
  • Inadequate school climate/Poorly organized and functioning schools/Negative labeling by teachers


  • Availability of alcohol and other drugs
  • Economic deprivation/Poverty/Residence in a disadvantaged neighborhood
  • Low community attachment


  • Association with delinquent and/or aggressive peers
  • Gang involvement/Gang membership
  • Peer alcohol, tobacco, and/or other drug use
  • Peer rejection

Protective Factors


  • Healthy / Conventional beliefs and clear standards
  • High expectations
  • Perception of social support from adults and peers
  • Positive / Resilient temperament
  • Positive expectations / Optimism for the future
  • Self-efficacy
  • Social competencies and problem-solving skills


  • Effective parenting
  • Good relationships with parents / Bonding or attachment to family


  • High quality schools / Clear standards and rules
  • Presence and involvement of caring, supportive adults


  • Presence and involvement of caring, supportive adults


  • Involvement with positive peer group activities


Kamradt, Bruce J. 2000. “Wraparound Milwaukee: Aiding Youth With Mental Health Needs.” Juvenile Justice Journal 7(1):14–23.

Mendel, Richard. 2001. “Provide Comprehensive Support and Assistance to Youth (and Children) With Behavioral Disturbances.” In Richard Mendel (ed.). Less Cost, More Safety: Guiding Lights for Reform in Juvenile Justice. Washington, DC: American Youth Policy Forum.

Milwaukee County Behavioral Health Division. 2003. Wraparound Milwaukee: 2002 Annual Report. Milwaukee, Wis.: Milwaukee County Behavioral Health Division, Department of Health and Human Services.


Bruce J. Kamradt
Wraparound Milwaukee
9201 Watertown Plank Road
Wauwatosa, WI 53226
Phone: (414) 257-7639
Fax: (414) 257-7575