March 29, 2010

System of Care Approaches in Residential Treatment Facilities Serving Children with Serious Behavioral Health Needs

Written by Kamala D. Allen, Center for Health Care Strategies, Sheila A. Pires, Human Service Collaborative, and Jonathan Brown, PhD, Mathematica Policy Research, this article writes, providing an appropriate continuum of mental health services for the estimated one in five children and adolescents in the U.S. who have a mental health disorder is imperative. While it is well established that such services should emphasize community-based care, children and youth with challenging behavioral health problems are often placed instead in residential treatment facilities (RTFs). A system of care is a strengths-based approach that recognizes the importance of family, school and community, and addresses the physical, emotional, intellectual, cultural, linguistic and social needs of every child and youth. Through this approach, families and youth work with public and private organizations to design a coordinated network of community-based services and supports. The federal Comprehensive Community Mental Health Services Program for Children and Their Families has funded systems of care for children's mental health in states, tribes and communities across the country, with demonstrated improvements in behavioral and emotional health. Insufficient home- and community-based options, financial incentives that drive residential placements, and reduced use of inpatient psychiatric care all contribute to increases in the use of RTFs. This paper describes the findings of a national survey of RTFs that serve children and youth with serious behavioral health challenges.