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SAMHSA’s Model Programs Web Site The programs featured on this site have been tested in communities, schools, social service organizations, and workplaces around the country. They have all shown solid proof that they have prevented or reduced substance abuse and related high-risk behaviors. The links shown here were those that struck my fancy. You may find it rewarding to examine all of them for yourself. Click here to see a matrix of all programs. Reconnecting Youth – school-based prevention program for youth in grades 9-12 at risk for school dropout. The youth may exhibit multiple behavior problems, including substance abuse. The program uses a partnership model. Brief Strategic Family Therapy (BSFT) – problem-focused and practical approach to the elimination of substance abuse risk factors. Successfully reduces problem behaviors in children and adolescents 6 to 17 hears old and strengthens their families. The program provides families with tools to decrease individual and family risk factors. Cognitive Behavioral Therapy for Child Sexual Abuse – A treatment approach designed to help children and adolescents who have suffered sexual abuse overcome PTSD, depression and other behavioral difficulties. Project ACHIEVE – An innovative school reform and school effectiveness program developed for use in preschool, elementary, and middle schools. Designed to help schools, communities and families develop, strengthen and solidify their youths’ resilience, protective factors, and self-management skills. ++++++++++ Cultural Competence in Serving Children and Adolescents With Mental Health Problems – Fact sheet from SAMHSA’s National Mental Health Information Center . Three pages of bare bones information and guidance. ++++++++++ NMHA Mental Health State Assessment Project In 2002 NMHA set out to assess the priority that state policymakers are giving to mental health services. The current economic landscape, threat of terrorism, and war make it nearly impossible to compare states or to properly assess the priority for mental health care in the country. The report finds that all states underfund mental health services and many of them have cut mental health funding. It anticipates that, as mental health services are cut, states will continue to pay for them in the form of emergency room visits, criminal justice costs, and inpatient care increases. This link will take to you to a single page fact sheet. ++++++++++ The Wraparound Approach In all likelihood the best known example of wraparound programs is Wraparound Milwaukee (At this link scroll all the way to the bottom of the page). Wraparound programs wrap individualized services and assistance around the child and his or her family, rather than shoehorning the child and family into an available array of services. In the wraparound philosophy, if a child and/or family needs a particular service and it is not available, then the program will find a way to make it happen. Wraparound Vermont This website from the University of Vermont was created to “facilitate collaboration in using the Wraparound Fidelity Index (WFI) and to promote communication within the service delivery evaluation field.” The WFI is an interview that measures the quality of wraparound services a family receives. It is composed of brief, confidential telephone interviews. EMQ Children and Family Services Project UPLIFT UPLIFT was California ’s first wraparound program and is a model for wraparound services for the state. UPLIFT is an intensive community-based service and support effort designed to deliver strength-based needs-driven individualized treatment and support services. It is considered a very successful example of the wraparound model. - Since UPLIFT started in 1994, 187 (86%) of the children and adolescents served have been maintained successfully within their families and communities.
- Since 1994, 67% of the 134 children and adolescents discharged have either successfully graduated from the program and transitioned to a less restrictive environment or have been completely removed from the county rolls in social services, mental health and juvenile probation.
This link will take you to the EMQ UPLIFT annual report for 2001. ++++++++++ Mental Health: Culture, Race and Ethnicity A Supplement to Mental Health: A Report of the Surgeon General Covers the four most recognized racial and ethnic minority groups in the United States . The Supplement pays special attention to vulnerable, high-need populations in which minorities are over represented. Findings from the Supplement: - Minorities have less access to, and availability of, mental health services.
- Minorities are less likely to receive needed mental health services.
- Minorities in treatment often receive a poorer quality of mental health care.
- Minorities are underrepresented in mental health research.
I downloaded the Executive Summary, all told about 25 pages. Printed copies of the report are also available. ++++++++++ Mentally Ill Tax Juvenile Jail System - This article from the Chicago Tribune examines the Cook County Juvenile Detention Center , the largest in the country. A recent study of the Center found that two out of three 10- to 18-year-old boys and nearly three out of four girls in the center have diagnosable psychiatric illnessses. Researchers have also documented a sharp increase in mental, emotional and physical disabilities among all children, especially black children. Such disabilities have increased 77 percent since the 1970s among blacks younger than 18, according to the National Institute of Mental Health. ++++++++++ Understanding the Effects of Maltreatment on Early Brain Development A Brevity subscriber gave this to me with the comment that it is the best synopsis available of the results of research into how the brain develops and the effects of maltreatment on brain development he has seen. With that recommendation I took a look, and he was right. A quote from this document: “…research is providing biological explanations for what practitioners have been describing in psychological, emotional, and behavioral terms. We are beginning to see the scientific “evidence” of altered brain functioning as a result of early abuse and neglect.” Also contains some very clear graphics and nice informational sidebars. From the National Clearinghouse on Child Abuse and Neglect Information, 19 pages. Downloadable. ++++++++++ Avoiding Cruel Choices: A Guide for Policymakers and Family Organizations on Medicaid’s Role in Preventing Custody Relinquishment This new report released by the Bazelon Center for Mental Health Law discusses States’ options for increasing access to mental health care without forcing parents to relinquish custody. The report discusses the use of TEFRA (Tax Equity and Financial Responsibility Act) and home- and community-based services (H&CB) as alternatives to custody relinquishment. The report and a fact sheet are available at the Bazelon web site. Both are downloadable pdf files. Readers may want to reference the new GAO report, Child Welfare and Juvenile Justice: Federal Agencies Could Play a Stronger Role in Helping States Reduce the Number of Children Placed Solely to Obtain Mental Health Services. To see it scroll down the page through six entries. ++++++++++ Mental Health Families and Children Archives I thought I had a pretty comprehensive set of resources on Mental Health in the Subject Library section of Brevity. This web site at the Colorado Parent Information & Resource Center adds considerably to the information I have. It lists articles and information on mental health resources. ++++++++++ GRAD (Global Risk Assessment Device) GRAD, developed at Ohio State University , allows juvenile justice professionals to input individual information about risk factors in 11 different domains (examples: family/parenting; sociability; traumatic events) in youths’ lives. The information can then be shared across systems of care to measure progress and identify service gaps. It helps formulate appropriate referrals, particularly for mental health services. With a one-day training, GRAD makes it possible to do assessments in about 20 minutes. Kids appear to be very comfortable with a professional using GRAD too. OSU offers some consultation to jurisdictions interested in developing their own GRAD project. This system is now available on the Internet. Check out GRAD on the web then contact Stephen Gavazzi at OSU at gavazzi.1@osu.edu ++++++++++ Trustworthy Brochures About Mental Disorders From About.com’s Mental Health Resources guide, a list of mental health topic links to downloadable brochures from a variety of federal agencies. Written for consumers, professionals and family members. ++++++++++ Throwaway Kids – A special report of The Journal News This special report from The Journal News, a newspaper serving Westchester , Rockland and Putnam , New York , investigates the residential treatment centers that provide education and health care to disturbed and disadvantaged youngsters. It was published in June, 2002. The series includes an examination of the inappropriate institutionalization of children who would have been served in a more homelike setting; examines the Wraparound Milwaukee approach - a successful program model that diverts kids away from institutionalization through the provision of a carefully crafted and unique program of services for each child and his/her family; and includes an article about one family’s experience with Wraparound Milwaukee. (I enjoyed reading this article. The family’s father said at one point that he was afraid to walk out of the shower because he never knew who would be in his house at any given time.) The report is in three parts. All three can be accessed from the first page of each part. Each part includes several sidebar articles. Begin by clicking here to get to Part One. ++++++++++ National Center for Mental Health and Juvenile Justice Publications NCMHJJ Research and Program Briefs include these two reports: - Funding Mental Health Services for Youth in the Juvenile Justice System: Challenges and Opportunities – The author of this paper is Bruce Kamradt, the Director of Wraparound Milwaukee. Kamradt looks at funding for mental health and substance abuse services for youth in the juvenile justice system. Describes current options. Includes a discussion of best practices and description of a successful program model.
- Screening and Assessing Mental Health and Substance Use Disorders Among Youth in the Juvenile Justice System - Written by two notable experts in the field, Thomas Grisso and Lee Underwood. Defines screening and assessment, for whom, why, for what purpose. Reviews screening and assessment instruments, criteria for selecting an instrument, concludes with recommendations.
On the same page you’ll find a number of other useful reports, including several on the treatment of girls in the juvenile justice system. ++++++++++ Los Angeles County Mental Health Court I had a really difficult time coming up with anything on the Internet about the Los Angeles Juvenile Mental Health Court. I was finally able to track down this article from the LA Times at the NAMI (National Association for the Mentally Ill) web site. The article will tell you how the court is organized and how it operates. If you want to know more, you can read about the juvenile mental health court in San Jose, Calif., CITA, which has been in operation since February, 2001. This link will take you to the Brevity Subject Library Mental Health page to scroll through its contents. ++++++++++ GAO Report: Thousands of Parents Across The County Give Up Children to Get Care A report released Monday, April 21 by the Government Accounting Office says that more than 12,700 children were placed in the child welfare or criminal justice systems in 2001 by their parents as the only way for the children to receive treatment for mental illnesses. The GAO report said that this number may only be a small fraction of the actual total. Thirty-two states, including the largest five, did not provide data on how many children with mental illness were sent to child welfare agencies to receive treatment. Data on the number of children who ended up in the criminal justice system were based only on 30 counties nationwide. Parents took these drastic steps because they were unable to cope with their mentally ill children or because of the cost of care, insurance problems or lack of access to services. The report notes that “Neither the child welfare not the juvenile justice system was designed to serve children who have not been abuse or neglected, or who have not committed a delinquent act.” The GAO recommends the Departments of HHS and DOB should consider the feasibility of tracking children placed by the parents in the child welfare and juvenile justice systems to obtain mental health services. Read Washington Post article about the report. To Read a one-page summary of Child Welfare and Juvenile Justice: Federal Agencies Could Play a Stronger Role in Helping States Reduce the Number of Children Placed Solely to Obtain Mental health Services and/or to read/download the complete GAO report, take the following steps: To read/download the report go to the GAO web site at www.GAO.gov. Click on GAO Reports - Click on Today’s Reports
- Click on April 21
- Click on 1, GAO-03-397
Click on Highlights to read a one page summary of the report. If you want to print the summary page, go to the complete report. The Highlight page won’t print by itself. The complete report is 66 pages. I downloaded 1-43 (or pdf page numbers 1-48). ++++++++++ BrainWonders: Helping Babies and Toddlers Grow & Develop This special web site is presented by Zero to Three. It has pages about how the brain develops within the context of relationships from conception through three years of age. The information here is intended for parents, child care providers, and pediatric and family clinicians, but if you’re not any of the above you can still read it. ++++++++++ An Act of Desperation – A series from the Tampa Tribune on the use of the Baker Act to send children psychiatric crisis units This three part series results from a statewide Tampa Tribune investigation of the use of the Baker Act. The Baker Act was passed to keep people out of mental institutions and to ensure patients receive fair hearings. The act was not intended for the use to which it has been applied by families, schools, courts and mental health counselors. It was used in 16,000 cases last year in which children were taken to crisis centers where they were often kept for days, put on prescription psychiatric drugs, and then released with only a recommendation they seek outpatient care. ++++++++++ Policing the Mentally Ill The Phoenix , Ariz. Crisis Intervention Team program is designed to reduce the number of violent confrontations police experience with the mentally ill. Roughly 100 Phoenix police officers have taken the 40 hour course, which features a roster of speakers including mental-health professionals, advocates, and patients. The program started in Memphis , Tenn. in 1987 after a widely criticized police shooting of a mentally ill man. To deal with mentally ill, cops act as “social workers” – Christian Science Monitor recent news article about the Phoenix program. Law Enforcement News 2000 People of the Year – MPD’s Crisis Intervention Team - An article published in Behind the Badge, the newsletter of the Memphis PD, describes the history and development of the Crisis Intervention Team approach to the mentally ill. ++++++++++ Strategies for Developing Treatment Programs for People With Co-Occurring Substance Abuse and Mental Disorders Developed by SAMHSA (Substance Abuse and Mental Health Services Administration), NCCBH (National Council for Community Behavioral Healthcare), and SAAS (State Associations of Addiction Services) to identify problems and seek solutions to the problems associated with the provision of services to people with co-occurring disorders. The report presents challenges to providing treatment, strategies and tools to overcome these challenges, and core competencies and training that should be acquired by staff. Downloadable pdf file about 50 pages in length. ++++++++++ Blamed and Ashamed: The Treatment Experience of Youth With Co-occurring Substance Abuse and Mental Health Disorders and Their Families I originally reported to you about this valuable book when it was published two years ago. The entire publication is now available on the SAMHSA web site to read and download. Published by the Federation of Families for Children’s Mental Health and Keys for Networking, Inc., Blamed and Ashamed offers cogent observations by the families of children with co-occurring disorders and the kids themselves, who were actively involved in the research for the book. Recommendations for providers, for family members, for youth, and for SAMHSA are straightforward and make great good sense. The information in this publication is not copyrighted and you are encouraged to copy and disseminate it. ++++++++++ Mental Health and Family Services Collaborate to Help Rural Youth The Pact 4 Families group is a collaborative of family services and mental health providers in rural four counties plus one community. The collaborative has more than 100 partners. Members include county social services, public health and corrections agencies, school districts, mental health providers and other child serving agencies. At the web site you’ll see all sorts of activities, programs, and projects run by the collaborative’s partners. In a new program, PRIDE 4, Pact 4 will develop and implement transitional programs for about 1,400 14-24 year olds with depression, anxiety, ADHD, bipolar disorder and schizophrenia. It is supported by a $500,000 SAMHSA grant. ++++++++++ Center for the Promotion of Mental Health in Juvenile Justice From Columbia University ’s division of Child Psychiatry, this web page provides expert guidance regarding best practices for psychiatric assessment and referral for youth in juvenile justice settings. It offers a range of training and technical assistance, including on-site training in the Voice-DISC administration and interpretation. ++++++++++ Key Principles of Integrated Treatment of Mental Illness and Substance Abuse The Mental Illness Education Project, Inc. has produced and now has available the first in a series of lectures by noted experts in mental health. The lectures are video-based. In the first, Dual Diagnosis, Kenneth Minkoff, M.D. addresses outlines the key principles of integrated treatment of mental illness and substance abuse. Key Principles: - When mental illness and substance disorder coexist, both diagnoses should be considered primary, requiring simultaneous primary treatment for each.
- Addiction treatment requires modification when people also have psychiatric disabilities and disorders.
- The most significant predictor of success is an empathic, hopeful, continuous care relationship, in which integrated treatment and coordination of care can take place through multiple treatment episodes.
The video is intended for mental health professionals and administrators in hospitals, clinics and mental health centers. The cost to individuals is $39.95. ++++++++++ Self-injury No Longer Rare Among Teens An article from the WebMD web site reports on a British study of 6,000 that shows that over their lifetime, 13 percent of 15- and 16-year-olds have carried out an act of deliberate self harm. The study found acts of self-harm four times more common among girls than boys. To learn more read the American Academy of Child and Adolescent Psychiatrists’ Facts for Families page, Self-Injury in Adolescents. ++++++++++ Juvenile Mental Health Court This article from The Mercury News describes the progress of the nation’s first juvenile mental health court. Since the court opened in February, 2001 CITA (Court for Individualized Treatment of Adolescents) has screened almost 200 cases and accepted 65 youths, ages 12 to 17. The court focuses on illnesses with a clearly biological cause: schizophrenia, bipolar disorder, attention-deficit hyperactivity disorder (ADHD), severe depression, social anxiety and autism. The article describes the weekly meeting of the team of mental health professionals, prosecutors, attorneys and probation officers to review progress and assess setbacks. ++++++++++ Among teens in juvenile detention, nearly two thirds of boys and nearly three quarters of girls have at least one psychiatric disorder Reporting in the December 2002, Archives of General Psychiatry, Linda Teplin, Ph.D., Northwestern University , and colleagues have found in a federally funded study that the rates of psychiatric disorder in teens in juvenile detention dwarf the estimated 15 percent of youth in the general population through to have psychiatric illness. This new study is the largest and most methodologically sophisticated of its kind and provides some of the first really solid information on the psychiatric health of kids in the juvenile justice system. Some figures from the study: - About half the detained teens abused or were addicted to drugs
- More than 40 percent had disruptive behavior disorders: oppositional defiant disorder and conduct disorder.
- When conduct disorder was excluded, nearly 60 percent of males and more than two-thirds of females met diagnostic criteria for, and also were functionally impaired by, one or more mental or substance use disorders.
Comments from the researchers: - “Youth with psychiatric disorders pose a challenge for the juvenile justice system and, after their release, for the larger mental health system.”
- “Our data highlight an important paradox regarding race/ethnicity. More than half of the youth in our juvenile justice system are African American or Hispanic. Therefore, most detained youth with psychiatric disorders are minorities. The prevalence, however, of many disorders is highest among non-Hispanic whites. Thus, white youth in the juvenile justice system may, on average, be more dysfunctional (have greater psychiatric morbidity) than minority youth.”
- “Females had higher rates than males of many psychiatric disorders, including major depressive episode, some anxiety disorders, and ‘other substance use disorders.’ Our findings confirm those of prior studies of adult female detainees and females with conduct disorders, which found that females have higher rates of psychiatric disorders than males.”
Read the NIMH News Release (single page) Read Psychiatric Disorders in Youth in Juvenile Detention as published in the Archives of General Psychiatry. (pdf file. 11 pages) ++++++++++++ Young People with Mental Health and/or Substance Abuse Disorders in the Juvenile Justice System October 10, 2002 , Dr. Joseph Cocozza and Laura Prescott addressed a Washington D.C. audience as part of the Center for Mental Health Services Insight Speakers Series. In that speech Cocozza stated that, in a review of the research on mental health issues among young in the juvenile justice system, he found anywhere from 75 percent to 100 percent of youth in the juvenile justice system meet DSM-IV criteria for mental illness, including substance abuse. A brief review of that presentation can be read here. If you’d like to see the entire speech I have a copy of it on videotape. It is available through our video lending library for up to three weeks. Here’s how to check out the videotape: We ask you to give us your credit card information. If you don’t return the videotape within the three week period or the video becomes damaged and unusable we use your credit card to purchase a replacement. If the tape comes back in good condition, we shred your credit card information. Email me if you want to check out this video. +++++++++++ Juvenile Offenders and Mental Health Disorders This new book by Dr. Lisa Melanie Boesky is focused on juveniles in residential facilities but is also just as relevant to the juvenile justice population in general. Discusses how mental health disorders specifically manifest in adolescent offenders. It covers ADHD, Depression, Bipolar Disorder, PTSD, Conduct Disorder, ODD, Learning Disorders, Fetal Alcohol Syndrome (FAS), Co-occurring Substance Abuse and Mental Health Disorders, Suicidal Behavior, and Self-Injurious Behavior. Available from the ACA (American Correctional Association). ++++++++++ NAMI, National Association for the Mentally Ill, and the Center for the Promotion of Mental Health in Juvenile Justice Collaborate The two organizations join together in a research project funded by OJJDP to examine the feasibility and the usefulness of standardized psychiatric assessments for youth in correctional settings. They will identify three pilot sites that will receive comprehensive consultation, screening tools, implementation guidance, and training at little or no cost. Read the details here. +++++++++ Lost Children: A look at kids, mental illness (and click on "related stories" for a complete list of the series articles) The Spokane Spokesman-Review has published a series of articles dealing with the state of mental health services for children in Washington . While this series will appear much the same as previous series of this type featured in Brevity, there are some unique aspects to it. Take a look at Classroom as therapy. If nothing else, you can be assured that the dilemma of the delivery of mental health services for kids looks very much the same all over the country. I’ll make the same offer I’ve made before. If you don’t want to spend the time downloading these articles and/or reading them on the internet, I’ll be glad to send you a hard copy of mine. Just send me your mailing address and tell me you want the Spokesman-Review series. ++++++++++ Promoting Positive Mental and Emotional Health in Teens: Some Lessons from Research
This is the latest in the Child Trends series on youth development. Child Trends reviewed nearly 300 research studies on teens’ mental health and emotional well-being. It includes two pages of “What Works” tables provide details on some of the programs and approaches likely to succeed. Eight pages, downloadable pdf file. ++++++++++ The MAYSI-2 The University of Massachusetts National Youth Screening Assistance Project (NYSAP) will provide you information about the use of the MAYSI-2, a brief screening instrument designed to identify potential mental health needs of youths as they make contact with the juvenile justice system. At this site you can find out more about it, how to get it, how to get permission to use it, as well as a variety of other useful information about this tool. This site offers information, technical assistance, and research services to juvenile justice entities that use the MAYSI-2. ++++++++++ National GAINS Center Online Tutorial Working Together for Change: Co-occurring Mental Health and Substance Use Disorders Among Youth Involved in the Juvenile Justice System. This is an adaptation of the GAINS Center ’s Juvenile Cross Training Curriculum. The Curriculum was designed to address major gaps in service provision for youth with treatment needs involved with the juvenile justice system. The online version supplies participating professionals with information to better understand the needs of juveniles with co-occurring disorders and to provide more effective treatment and management. Main topic areas: - Overview of the juvenile justice and treatment systems
- Screening and Assessment tools
- Effective treatment approaches
- Strategies for improving communication among systems.
Read the details at the GAINS site. ++++++++++ Maine Press Herald Mental Health Series The Portland Press Herald has done a remarkably in-depth series on the state of mental health services for kids in Maine . Reporter Barbara Walsh has produced a week-long series of articles that cover virtually every aspect of mental health, kids and their families in the state. Read the series online or download it article by article (about 100 pages all told). I’ll make the same offer I did on a previous series like this. Send me an email with your mailing address and I’ll make a copy of my copy for you. There’s no sense in spending hours downloading when it’s already done. This is the latest in the series on youth development It includes provide details on some of the programs and approaches likely to succeed. Eight pages, ++++++++++ The University of Massachusetts ) will provide you information about the use of the as they make contact with the juvenile justice system. At this site you , as well as a variety of other useful information about this tool. This site offers ++++++++++ This is an adaptation of the GAINS Center ’s Juvenile Cross Training Curriculum. The Curriculum was The online version and to provide more effective treatment and management. Main topic areas: Read the |
Subject Library 
