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SAMHSA News - Volume X, No. 2, Spring 2002

Systems of Care Help Youth with Serious Emotional Disturbance

Comprehensive systems of care enhance the social functioning, improve school attendance and grades, and reduce severe behavioral and emotional problems and contact with law enforcement in children with mental health problems according to the findings of a SAMHSA report. The findings are contained in the Annual Report to Congress on the Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program, 1999.

After 2 years of receiving services, 42 percent of the children in the program showed a significant reduction in severe behavioral and emotional problem symptoms. An additional 48 percent of the children were stabilized. The report also shows that after 1 year in systems of care, the percentage of children with serious emotional disturbances receiving average or above-average grades in school increased nearly 20 percent.

Likewise, the percentage of children in special education classes receiving average or above-average grades increased by nearly 15 percent. Other data indicate that systems of care lead to other marked improvements in the lives of children, such as significantly fewer arrests and more stable living arrangements.

Serious emotional disturbances are diagnosed behavioral, emotional, and mental disorders that result in functional impairment and substantially interfere with or limit major life activities. Systems of care help children with serious emotional disturbances and their families by integrating community services into a single, comprehensive, family-focused, culturally competent, and community-based service system that is able to meet their highly diverse and changing needs.

Since the enactment of the Children's and Communities Mental Health Services Improvement Act of 1992, the Comprehensive Community Mental Health Services for Children and Their Families Program has supported the development of systems of care in communities across the United States. This report presents data accumulated through August 1999 from 31 grant communities that established systems of care for approximately 40,000 children and their families.

"Many people do not realize that about one in 10 children in the United States has a serious emotional disturbance, and one in five has a diagnosable mental health disorder," said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W. "The data illustrate the progress that 'systems of care' are making. Our job now is to work with states and communities to use our latest findings about 'systems of care' to implement effective treatments, services, and supports nationwide."

In addition to positive outcomes for children, the report shows that systems of care also are achieving another important objective, which is actively involving family caregivers in the decision-making process for their children's treatment plans. Nearly 75 percent of those families surveyed indicated that they were asked for ideas and opinions concerning their child's treatment, and more than 75 percent said they "always" or "usually" had a choice in the range of services their children received. Also, more than 75 percent rated the quality of their child's mental health services as "excellent" or "good."

"Active family involvement is one of the keys to success for systems of care," said Bernard S. Arons, M.D., Director of SAMHSA's Center for Mental Health Services. "Families actually take the lead in helping their children get the effective, individualized services that they need," he added.

For a copy of the report, contact SAMHSA's National Mental Health Information Center at P.O. Box 42557, Washington, DC 20015. Telephone: 1 (800) 789-2647 or (866) 889-2647 (TDD). Web access:

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