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Health Care and Systems of Care: We Work Together

Health care providers and children’s mental health advocates want the same thing: the most appropriate care to support healthy children, youth, families, and communities. Systems of Care can help achieve that goal. A System of Care is a coordinated network of community-based services and supports that is organized to meet the challenges of children and youth with serious mental health needs and their families.

Meeting the Mental Health Needs of Children and Youth Is Critical

Primary care providers are often the first place that families turn when their children are having a mental health crisis, yet many providers struggle to provide the care these children need. Consider the following:

  • Mental health needs among children and youth are common. In fact, 5 percent to 9 percent of children and youth have serious mental health needs.1
  • Mental health problems may present as physical symptoms. The American Academy of Family Physicians lists many physical symptoms as possible signs of mental health problems, including back or chest pain, digestive concerns, changes in appetite or sleep patterns, fatigue, headaches, and shortness of breath, among others.2
  • Both caregivers and youth are likely to raise concerns about mental health with primary care providers. In one study, more than 40 percent of people 12 and older who had experienced a major depressive episode saw a health professional or had used a prescription drug to treat their symptoms.3
  • One-half of children with serious mental health needs are not getting the help they need.4 Treating mental health concerns in a primary care setting brings many challenges, including brevity of patient visits, lack of specialization, inadequate insurance reimbursements, and limited access to community services for referral.5
  • Unmet mental health needs pose serious health risks. Studies have shown that children and youth with unmet mental health needs are at greater risk for suicide, hospitalization, and substance abuse problems, even into adulthood.6

Systems of Care Can Help

When children and youth with serious mental health needs receive coordinated services through Systems of Care, they can and do get better.

Systems of Care are...

  • Comprehensive. Partners include health care, child welfare, juvenile justice, education, mental health, and substance abuse professionals, as well as families, faith-based organizations, and other community partners.
  • Guided by common core values. Systems of Care are family-driven and youth-guided, culturally and linguistically competent, and community-based.
  • Effective and accountable. As part of a nationwide initiative, each System of Care is evaluated on the progress it makes toward helping children, youth, and families. Data are gathered regularly to ensure Systems of Care are financially and ethically accountable.

Working Together Benefits Everyone

Systems of Care can help relieve pressure on already-strained health care systems. Because Systems of Care emphasize community-based services, children and youth are less likely to receive treatments of last resort, such as institutionalization. In fact, patients often can be referred to successful nonmedical services. Meanwhile, System of Care case managers facilitate communication among all systems serving a child or youth. This allows health care workers to better understand and treat their patients’ conditions, while freeing up medical resources and staff time to treat others with serious needs.

Partnerships between health care providers and Systems of Care can achieve the following:

  • Increased family cooperation. Systems of Care involve families as partners. Doing so not only ensures that services and supports are relevant to their children’s needs, but also increases the likelihood that families will comply with treatment plans.
  • Fewer recurring health problems for children and youth. One study found that, after 24 months of involvement in Systems of Care, disruptions in children’s regular activities due to recurring health problems fell by nearly 25 percent.7
  • Better behavioral outcomes. In the same study, nearly one third of all children showed a decrease in behavioral symptoms during the first 12 months in a System of Care. Nearly one half showed improvement within 24 months.8
  • Improvements for children and youth who have experienced trauma. After 6 months of services, 18 percent of children in Systems of Care showed improvement on internalizing symptoms (e.g., depression, anxiety), and 21 percent showed a decrease in externalizing symptoms such as aggression. Suicidal thoughts also decreased.9

As a primary care provider, you may be the first to see that a child is struggling with unmet mental health needs. While you may be trained to “look,” also take the time to “listen.” The family’s trust in you may make all the difference in connecting them with appropriate mental health services—their child’s path to a better life.


  1. President’s New Freedom Commission on Mental Health. (2003). Final Report. Retrieved from http://govinfo.library.unt.edu/mentalhealthcommission/reports/FinalReport/downloads/FinalReport.pdf Exit Disclaimer (PDF - 1.35 MB)
  2. American Academy of Family Physicians. (2010). Mind/Body Connection: How Your Emotions Affect Your Health [Webpage]. Retrieved from http://familydoctor.org/782.xml?printxml Exit Disclaimer.
  3. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2012). Results from the 2010 National Survey on Drug Use and Health: Mental Health Findings. NSDUH Series H-42, HHS Publication No. (SMA) 11-4667. Rockville, MD: Author. Retrieved from http://www.samhsa.gov/data/NSDUH/2k10MH_Findings/2k10MHResults.htm#Ch3
  4. President’s New Freedom Commission on Mental Health. (2003). Final Report. Retrieved from http://govinfo.library.unt.edu/mentalhealthcommission/reports/FinalReport/downloads/FinalReport.pdf Exit Disclaimer (PDF - 1.35 MB)
  5. Williams, J. W., Ross, K., Dietrich, A. J., Ciotti, M. C., Zyzanski, S. J., Cornell, J. (1999). Primary care physicians’ approach to depressive disorders: effects of physician specialty and practice structure. Archives of Family Medicine 8(1), p. 58–67. Retrieved from http://triggered.edina.clockss.org/ServeContent?url=http%3A%2F%2Farchfami.ama-assn.org%2Fcgi%2Freprint%2F8%2F1%2F58 Exit Disclaimer; Lehmann, C. (2002, April 5). Guide helps clinicians manage mental health problems. Psychiatric News, 37(7). Retrieved from http://psychnews.psychiatryonline.org/newsArticle.aspx?articleid=104500 Exit Disclaimer
  6. See for example, Weissman, M. M., Wolk, S., Goldstein, R. B., Moreau, D., Adams, P., Greenwald, S., et al. (1999). Depressed adolescents grown up. Journal of the American Medical Association, 281(18): 1701–13.
  7. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. (2009). The Comprehensive Community Mental Health Services for Children and Their Families Program: Evaluation Findings—Report to Congress, 2009. Washington, DC: Author. Retrieved from http://store.samhsa.gov/shin/content/PEP12-CMHI2009SUM/PEP12-CMHI2009SUM.pdf (PDF - 3.56 MB)
  8. Ibid.
  9. U.S. Department of Health and Human Services. (2011). Helping Children and Youth Who Have Experienced Traumatic Events. Washington, DC: Author.

If you or someone you know is in crisis and needs to talk, please call 1-800-273-TALK (1-800-273-8255).

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