IN INVE VESTIN STING G IN IN LIES FA FAMI MILIES
“A misbehaving child is a di a disc scouraged ouraged chi hild. ld. Eac ach child ld ne need eds s con ontin tinuou uous s en encou ouragement ragement ju just st as as a plant needs water” (Rudolph Dreikurs, 1964)
Cu Current rrent Pro Progra gramming mming
Cent ntral al MN Ment ntal al Heal alth th Cent nter Current nt Model Adult Services: Children’s Services: Grant Opportunities: * Outpatient * Outpatient /Schools *Children’s 0 -5 Grant * Specialized * Day Treatment *Adult Integrative Grant * CD Services * Crisis Services
Out utpati patient ent Serv rvic ices • Individual and Couples Therapy • Group therapy • Day Treatment • School Counseling for children and adolescents • Psychiatry • Psychological testing • Chemical Dependency programming What’s missing . . . . .? Fa Family ily Fo Focused sed Su Supp pport ort
Sp Specialty ialty Progr grams ams • ARMHS-Adult Rehabilitative Mental Health Services • ACT-Assertive Community Treatment • IRTS- Intensive Residential Treatment Services • TCM-Adult and Child Targeted Case Management • Crisis Mobile Unit, Crisis beds and Detox What’s missing....? In In-hom home e Fa Fami mily y Su Suppo pports ts
Minnesota Department Of Human Services Children’s 0-5 Grant And Adult Integ egrati rative ve Grant : The Minnesota Department of Human Services PURP RPOS OSE: Children’s Mental Health Division has worked with many agencies and communities to create an early childhood mental health system of care to meet the needs of the state’s children. This requires integrating services to include the many systems that serve young children and their families.
Minnesota DHS Children’s 0 -5 5 Gran ant • Targets children age 0-5 specifically focusing on the effects of trauma on development. • Creates trauma – informed care systems by providing training opportunities for mental health professionals at community mental health centers. • Addresses the impact of trauma and subsequent changes in the child’s behavior, development and relationships. • Supports and promotes positive and stable relationships in the life of the child. (University of Minnesota Extension, March, 2011)
Mi Minneso sota ta Depar partm tment ent of Hum uman n Serv rvices ces Adul ult Integrati egrative e Gra rant • Serves primary caregivers diagnosed with serious mental illness or serious and persistent mental illness with 0-5 year olds. • Research is being conducted to determine the most resourceful ways to meet the needs of this population. • Mental Health Practitioners working with adults will be trained to identify developmental concerns in 0-5 year olds to refer for early intervention services. • Partnering with the Children’s 0 -5 grant to include trauma informed care for the families experiencing the effects of past or present trauma. • Assessing and identifying the best course of treatment for the whole family to prevent future patterns from the effects of mental illness and poverty.
Ov Over eral all l An Anal alys ysis is
Posit sitive ive Programmin ramming • Each individual service at CMMHC is delivering a client driven recovery model approach based on the level of care assessed. • Outpatient and specialty services provide a wide range of service delivery models to choose from each within their own specific programs. • We offer the above services all “under one roof” to enhance service delivery and offer clients easier access without duplication. • We are on the cutting edge in serving 0-5 year olds and their families through the Children’s 0 -5 and Adult Integrative grants.
Ana naly lysis sis Cont nt. However….. • Day to day functioning of each separate service often promotes a tunnel vision approach. • Focus is on resolving crisis situations and maintaining mental health stability of clients rather than a preventative focus. • A strategic plan is needed to continue implementing services resulting from the grants. • Staff need to partake in changes within the agency by participating in specialized training opportunities and applying their expertise.
Ana naly lysis sis Cont nt. • There is limited support for parenting with serious mental illness. • There is limited support for 0-5 year olds in need of mental health services. • To reach both these populations delivery modes need to be adjusted. • There is a need for mental health professionals trained in trauma informed care to work with young children and their families. • Collaboration and communication between adult and child services needs to increase to establish effective, unified care.
Enc ncoura uraging ging • O n the brink of a systems change that can lead other community mental health centers. • M oving towards a holistic approach of treatment centered on health and wellness of the whole family unit. • Developing a plan that includes trauma informed care and secure attachment focus. • A bility to step out of the individual focused model and expand. • A bility to integrate services already in place with evidence based family support services.
Pr Pres esenting enting Re Reaso asons ns fo for r Program Changes…
erty …..need supports to….. thriv thrive. Chi hildr ldren en in in pov overty
Definition tion of 'Return urn on Investm stment ent - ROI'; a performance measure used to evaluate the efficiency of an investment or to compare the efficiency of a number of different investments. To calculate ROI, the benefit (return) of an investment is divided by the cost of the investment; the result is expressed as a percentage or a ratio. (www.nvestopedia.com/terms/r/returnoninvestment.asp)
Inve vestment stment: Integrated adult and children’s services Ben enefit efit: : Healthy children and families Cos ost: Agency implementation Res esult: lt: The following statistics a re greatly reduced…..
Env nvir ironmental nmental Ris isk Fact ctor ors • “Research suggests that up to 50 percent of the impact of income on children’s development can be mediated by interventions that target parenting” • “Inadequate screening prevents recognition of social, emotional, and behavioral problems” • “40 percent of preschoolers in specialty mental health services are children of color” • “Nearly two to three times more pre -school age children exhibit symptoms of trauma- related impairment than are diagnosed” • “Children age 6 -10 years old were four times more likely to access developmental services than birth to two years old”
Furthe ther r St Studie ies • “Unfortunately , studies have shown that children from economically disadvantaged homes often know half as many words as children from high-income households. Worse still, fewer than half of low-income children are prepared to start kindergarten, compared to more than 75% of toddlers from high-income homes” (Thrive by five, Washington State, 2013) • Another study found that “children who had four or more adverse childhood experiences were more likely to suffer from a range of chronic diseases as adults, including heart and lung disease, as well as increased risk for depression, alcoholism, suicide attempts and drug use” (The San Francisco Chronicle, 6/23/13).
Addre dress ssing ing Eth thni nic c an and Rac acia ial l Min inoritie rities • As clientele changes to include more minorities the agency must adapt to accommodate all ethnic and racial backgrounds. • Understanding cultural differences specific to family belief systems will lead to better overall implementation of services. • “ Children in America are the poorest members of society. One in five children live below the federal poverty line, and almost one in two are poor or near poor, with a disproportionate burden falling on the very young, racial and ethnic minorities, Native Americans and children from immigrant families” (The Washington Post, 5/14/13).
Fun undam ament ental al Ideal als “Love and belonging are irreducible needs of all men, women, and children. We’re hard - wired for connection- it’s what gives purpose and meaning to our lives. The absence of love, belonging, and connection always leads to suffering” (Brown, B, 2012).
Ear arly ly Brai ain n Deve velopment lopment • Infants of depressed mothers are found to be more likely at risk to develop mental and socioemotional problems. • Studies indicate that “as the mother -infant bond develops through an accumulation of social interactions, the behavioral and neural underpinnings of this relationship also change in concert with one another” • “One critical way to map the young child’s move from dependence to competence is through the study of self- regulation” • “Children internalize the regulating speech of their caregivers, which becomes part of the child’s internal self - regulatory dialogue” • “Parent -child interaction is an important mediator of risks that affect both language and emotional expressiveness and regulation ” (Ayoub, C., et al, 2011).
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