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Children's Mental Health Services
Service Delivery System Vision and Values:
The service delivery system for public mental health services for children is based on the following vision and values:
Vision
- To provide quality family-focused, community-based mental health services and supports to children and their families.
- Services and supports for children and their families will be individualized based on family-identified strengths, needs, preferred services and supports, and outcomes.
- Services and supports will be flexible and will fit the children and families.
- Children and families will have access to an array of mental health treatment services and supports provided through local mental health authority provider networks, as well as access to informal and natural supports preferred by the children and families.
- Families will be included as full partners in all aspects of the treatment of their own children. Families will be included at state and local levels of planning, policy development, service delivery, and evaluation.
- There will be an increasing commitment to the development of a service delivery system that is sensitive and responsive to cultural diversity.
Crisis hotline:
A telephone service available 24 hours a day, seven days a week that you can call to get information, support and referrals to help you and your child when your child is experiencing a psychiatric crisis.
Screenings:
A process where a staff person from the local mental health authority/community mental health center talks to you and your child, either face-to-face or over the phone, to gather information to find out if there is a need for a detailed mental health assessment. If you are not the parent, but the legally authorized representative, the staff person will talk with you.
Assessment:
There are several steps to completing an assessment. The first part is to determine whether or not your child is eligible for services from the local mental health authority. In order to be eligible, your child must meet the definition of "priority population." To be in the priority population, your child must be between the ages of 3 through 17 with a diagnosis of mental illness who exhibit serious emotional, behavioral or mental disorders and who:
- Have a serious functional impairment
- Are at risk of disruption of a preferred living or child care environment due to psychiatric symptoms: or
- Are enrolled in a school system's special education program because of a serious emotional disturbance.
Case/service coordination:
Your local mental health authority provides services that help your child access needed resources and services. For children with less intensive needs, this service is called case coordination. The case coordinator will also coordinate your child's treatment, provide continuity of services, and plan for the services needed by your child when he/she completes their treatment.
For children with more intensive needs, the local mental health authority/community mental health center provides service coordination to help your child access needed medical, social, educational and other appropriate services that will help your child achieve a quality of life and community participation acceptable to you and your child. Service coordinators also coordinate your child's treatment, provide continuity of care and develop a plan for the services needed by your child when he/she completes his/her treatment.
Your service coordinator also:
- Helps you when there is a need for crisis prevention and management, by locating and coordinating emergency services in order to prevent the crisis from getting worse.
- Is responsible for monitoring the services your child receives to see if the services are effective, or if your child needs additional or different services.
- Is responsible for identifying and arranging for the delivery of the services and supports that you have discussed with them and that you believe will address the child's needs and desires.
Developing your child's' treatment plan is a collaborative process involving you, your child (if old enough to participate) and the staff person with whom you are working. It will include goals and objectives that are measurable, so that you and/or your child can tell if he or she is making progress. The treatment and supports should be individualized and reflect the needs and preferences of you and your child, focusing on his or her strengths.
Skills training:
Skills training provides your child the opportunity to learn and improve the skills that they need to function as appropriately and independently as possible in the community. Skills training is designed to maintain the child's quality of life. This service includes, but is not limited to activities and training to address their mental illness or the problems that result when their symptoms interfere with functioning in their living and learning environment. As much as possible, skills training should be done within a natural setting, such as home or school, rather than in the center's offices.
Respite services:
Respite care is designed to provide a break from the stress that results when families are taking care of a child with mental illness every day. Respite care can be either provided in the home by respite staff (called community-based respite care) or it can be provided at a temporary residential placement outside the child's usual living situation (called program-based respite care.) Respite services can be planned ahead of time or provided in a crisis.
Medication-related services:
If your child is prescribed medication, there are several services that are provided as a part of your child's care:
- If he or she takes the medicine at the community center, a licensed nurse or other qualified and trained staff being supervised by a doctor or registered nurse will provide or administer it.
- This person will also be responsible for monitoring your child's medication, by assessing the impact of the medicine, including how well the medicine is working, if there are any side effects or adverse effects or if your child is experiencing any possible toxic reactions to the medicine.
- Appropriately trained staff will also teach your child and/or family member the knowledge and skills needed to be able to administer and monitor the medication at home.
- The doctor will be responsible for managing your child's medication to determine if his/her symptoms are staying the same, getting worse, getting better or clearing up completely. The doctor will evaluate the effectiveness of the prescribed medication, the dose (how much), the frequency (how often) and whether or not a different medication should be tried, and when.
- Your local mental health authority is responsible for ensuring that your child receives his/her prescribed psychoactive medication, under certain circumstances. Your child's medication will be provided to you if:
- you have no other means of paying for this medicine
- the medicine has been determined to be medically necessary
- it is prescribed by an authorized representative of the local mental health authority
- your child is receiving services and registered in TDMHMR's management information system, called CARE.
- you have no other means of paying for this medicine
If a child is experiencing a psychiatric crisis that can't be stabilized in a community setting, then short-term (usually 24 hours) residential services are provided. Intensive crisis residential services may be located in a variety of settings, including hospitals, therapeutic foster homes, group homes, and crisis stabilization units or crisis beds in residential treatment centers.
Inpatient services:
Hospital services provide 24-hour care to children who cannot be stabilized in a less restrictive environment. Services are designed to provide safety and security during an acute psychiatric crisis. The staff provides intensive interventions designed to relieve the child's acute symptoms so that the child can return to their community.
Optional services:
The following services may also be provided at your local mental health authority, depending on the resources that are available.
Wraparound planning:
Wraparound planning is a way of delivering services, not a particular service or program. It is a way of planning treatment that focuses on the strengths of your child and your family. Your and your child decide who would be most helpful in participating on your child's "wraparound team" and, as a team, you identify the services and supports that are the best fit for meeting the needs of your child, and reflect your values and preferences. These services and supports will include informal and natural supports that are available within your community.
Counseling:
Individual, group and/or family counseling designed to resolve problems that result from the child's mental, emotional or behavioral disorder. An appropriately licensed professional will provide this service.
Family skills training:
Families may also receive skills training. Family training is provided face-to-face to the family of a child to help the family understand the effects and treatment of emotional, behavioral and mental disorders. The training is designed to improve the symptoms of the child's disorder.
School-based services:
Counseling, skills training or day treatment provided on a school campus.
Rehabilitative day treatment:
A community-based program that operates during the daytime and provides an integrated set of services and supports that focuses on improving the functioning and behavior of the child. Day treatment may include counseling, family training, skills training, and crisis management.
Acute day treatment for children:
An intensive, short-term program provided during the day for children who need a team of professionals to help stabilize their acute and severe psychiatric symptoms. The environment is highly structured and provides constant supervision. Children may include medication-related services, individual, group and family counseling, skills training, family training, and crisis management.
Flexible community supports:
Supports provided to assist a family and their child to:
- identify and use non-clinical/non-professional community resources
- reduce the symptoms of the child's disorder(s)
- maintain the quality of life
- promote family integration
In-home crisis intervention:
Crisis intervention and supports provided in the home to assist children and their families manage an identified crisis and keep the child with the family or primary caregiver. This service is provided to a child who is at risk of being placed outside the home. In-home crisis intervention may also be provided in other community settings.
Therapeutic foster care:
Therapeutic Foster Care is when trained foster parents provide 24-hour care in their home for children who are temporarily unable to live with their parents or primary caregivers. Services and supports include family skills training for the natural parents/primary caregivers; training and support for the foster parents; crisis management; skills training and individual, group and family counseling.
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