RD1 - Final Report of the Child-Adolescent Work Group - Volumes I and II

  • Published: 1985
  • Author: Department of Mental Health and Mental Retardation
  • Enabling Authority: Work Group convened at the request of the Commissioner of the Department of Mental Health and Mental Retardation.

Executive Summary:
Joseph J. Bevilacqua, Ph.D., Commissioner of the Department of Mental Health and Mental Retardation, convened a broad-based Child-Adolescent Work Group in spring 1985, with the mandate to review Virginia's child-adolescent mental health system and to make policy and resource development recommendations. This group, chaired by Dr. Robert Cohen, Director of Virginia Treatment Center for Children, met over a six-month period to:

• Articulate a specialized service system model.

• Assess the current system against that model.

• Review interagency service collaboration efforts.

• Develop resource development strategies, including a proposed FY 1986-88 budget initiative for community services board program development.

• Analyze roles and functions of community services boards, state facilities, other child-serving agencies, and private sector with recommendations for policy development to improve the effectiveness of the overall system in serving young people and families.

The group's review of available data clearly showed that the current child-adolescent mental health system is seriously lacking in service capacity, particularly in the area of community-based service. Many CSBs are able to provide only general outpatient services and cannot meet critical needs for specialized intensive outpatient/day services, residential services, or prevention/early intervention programs. Capacity problems within the public inpatient system, due in part to the lack of development of community services, were also identified as a critical issue. Lack of a clear policy infrastructure for the development and management of a child-adolescent mental health system was also noted as hindering service planning and delivery, as was the lack of adequate information system/database. The group also concluded that problems in interagency coordination in planning and funding of services led to a fragmentation and inefficiency in resource use.

The group made a series of recommendations for Department action in the areas of policy development, interagency coordination, resource development, and planning/data capacity.

These recommendations included:

• A major budget initiative totalling $9.1 million for child and adolescent community services in FY 1986-1988. This initiative would allow for expansion of specialized child-adolescent outpatient and case coordination services as well as the development of residential treatment, day support, and specialized prevention/early intervention programs.

• Adoption of policy to designate a target population and model service system for children and adolescents.

• Use of Federal block grant set-aside funds for development this fiscal year of CSB child-adolescent services focused on interagency collaboration.

• Policy guidelines to develop CSB-facility regional partnerships.

• Adaptation of current department patient management guidelines for children and adolescents.

• Thorough study of multiagency funding mechanisms with demonstration projects to test the feasibility of various options for improving state and local funding and service coordination.

Overall, the Work Group concluded that major investments in both dollars and effort are needed to remedy serious problems in the current child-adolescent mental health service system. The needs for services were seen as great, and the social-economic costs for ignoring them even greater.