Transforming Mental Health Care for Children andTheir Families
American Institutes for Research
Management and Training Innovations, Inc.
University of South Florida
Portland State University
Human Service Collaborative
California Department of Mental Health In April 2002, the President’s New Freedom Commissionon Mental Health was created by executive order to studythe mental health care delivery system in our nation and tomake recommendations for improvements so that individ-uals with serious mental disorders can live, work, learn,and fully participate in their homes and communities. In itsreport,
“Achieving the Promise: Transforming MentalHealth Care in America,”
the commission provided strate-gies to address critical infrastructure, practice, and re-search issues. This article focuses on the work of thecommission’s Subcommittee on Children and Families, de-scribing its vision for mental health service delivery for children and providing suggestions for strengthening com-munity-based care for youths with or at risk of behavioralhealth disorders. Training, research, practice, and policyimplications for psychologists are discussed.Keywords:
children’s mental health, systems of care, trans-formation
ental health problems in children and adoles-cents have created a “health crisis” (Satcher,2000, p. 1) in this country. These problemsaffect a growing number of youths, they impact thesechildren and their families in all spheres of their lives, andtheir consequences are costly and often tragic. Recentstudies indicate an alarmingly high prevalence rate, withapproximately 1 in 5 children having a diagnosable mentaldisorder and 1 in 10 youths having a serious emotional orbehavioral disorder that is severe enough to cause substan-tial impairment in functioning at home, at school, or in thecommunity (Friedman, Katz-Leavy, Manderscheid, &Sondheimer, 1996). The National Institute of MentalHealth’s National Advisory Mental Health Council, Work-group on Child and Adolescent Mental Health (2001) con-cluded that “no other illnesses damage so many children soseriously” (p. 1).In conjunction with this prevalence rate, there is anextremely high level of unmet need. It is estimated thatabout 75% of children with emotional and behavioral dis-orders do not receive specialty mental health services (Rin-gel & Sturm, 2001). Former Surgeon General DavidSatcher, at his National Conference on Children’s MentalHealth, stated that “growing numbers of children are suf-fering needlessly because their emotional, behavioral, anddevelopmental needs are not being met by those veryinstitutions which were explicitly created to take care of them” (Satcher, 2000, p. 1). Yet despite these levels of prevalence and unmet need and the serious impact of mental health problems on the functioning of our children,our nation has failed to develop a comprehensive, system-atic approach to this crisis in children’s mental health. Thisarticle highlights the strategies put forth by the Subcom-mittee on Children and Families of the President’s NewFreedom Commission on Mental Health to transform men-tal health care for children and families.
Although the mandate of the commission focused onintervention for children with serious emotional disorders,the subcommittee expanded this mandate to include inter-vention for children at risk for mental disorders as well asprevention of mental health problems and promotion of
Larke Huang, American Institutes for Research, Washington, DC; BethStroul, Management and Training Innovations, Inc., Fairfax, Virginia;Robert Friedman, Department of Child and Family Studies, Louis de laParte Florida Mental Health Institute, University of South Florida; PatriciaMrazek, Rochester, Minnesota; Barbara Friesen, Research and TrainingCenter on Family Support and Children’s Mental Health, Portland StateUniversity; Sheila Pires, Human Service Collaborative, Washington, DC;Steve Mayberg, California Department of Mental Health, Sacramento,California.Larke Huang and Steve Mayberg served as co-chairs of the Subcom-mittee on Children and Families that was established as part of thePresident’s New Freedom Commission on Mental Health; the remainingauthors served as consultants to the commission in the area of children’smental health. This article is based on the ﬁndings and recommendationsof the Subcommittee on Children and Families.Correspondence concerning this article should be addressed to LarkeHuang, American Institutes for Research, 1000 Thomas Jefferson St.,NW, Washington, DC 20007. E-mail: firstname.lastname@example.org
This article is not the ofﬁcial report of the Subcommittee onChildren and Families of the President’s New Freedom Commission onMental Health. The content of this article reﬂects the discussions of thesubcommittee and its expert consultants. It does not reﬂect the position of the President’s New Freedom Commission on Mental Health or anyagency of the United States Government.
Copyright 2005 by the American Psychological Association 0003-066X/05/$12.00Vol. 60, No. 6, 615–627 DOI: 10.1037/0003-066X.60.6.615