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This chapter reviews studies of mental health service need and use in children involved in the child welfare system. It presents two comprehensive views: one of the research literature leading up to the NSCAW study, and another that depicts mental health service use in this population over a full 36 months. It considers three distinct age groups of children: those aged 2 to 5 years, those 5 to 10 years, and those 11 years or older. In addition to offering the most detailed examination of the use of mental health care by the younger children involved in child welfare, the chapter is perhaps the first study that uses a measure of developmental functioning to examine need for care in the youngest group (2-5 year olds). The striking finding is the larger gap between need and use for this youngest segment of the NSCAW cohort. Meanwhile, the findings about the powerful role of race/ethnicity in use patterns confirms at the nationwide level major findings from all local studies that have examined this question.

This chapter shows a high level of continuity in mental health care use over the 36-month NSCAW study period. The pattern of continuity is robust across methods, which confers additional confidence in the finding. This hopeful finding suggests not only that the child welfare system serves as a gateway to the mental health system, but also that the pathway through it to mental health service survives termination of child welfare system involvement.

This chapter is a casebook of specific examples, drawn largely from interviews conducted with community researchers studying different aspects of children's health. The cases are intended to serve as a reference guide for those wanting to conduct collaborative community research.

This chapter outlines key principles of collaboration that can guide efforts to involve consumers, family members, providers, administrators, and community members more fully in child mental health services research efforts. It then highlights opportunities for collaboration across the research process, from the development of guiding research questions, to study methods and procedures, to interpretation of study results and dissemination activities. Examples of the challenges that arise in collaborative efforts with youth and their families, providers, systems, and communities are discussed. Finally, a discussion of next steps for child mental health services research is offered.

This chapter gives an overview of the wide range in capacity and availability of mental health services around the globe. The first section discusses the concepts, definitions, measurement instruments, and sources of data bearing on global mental health and mental illness. That information provides background for the balance of the discussion by exposing the dearth of system-level instruments and readily comparable global data to help guide international public mental health policy. This is followed by an exploration of selected data on mental health systems around the world. Finally, the chapter presents a brief summary of mental health-related activities by leading international agencies.

This chapter examines pathways to the service system and the effects of stigma on both access to and utilization of mental health services. It first presents an overview of the process of seeking mental health treatment in community-based settings and briefly discusses stigma and financial barriers to mental health care. It then explores some of the most significant public health campaigns targeting the stigma associated with mental illness and treatment seeking. Finally, it examines a range of policy initiatives that have sought to eliminate or reduce financial barriers that stand between treatment need and treatment receipt.

Community behavioral health organizations (CBHOs) are the foundation of mental health service delivery in the United States for the more than 45 million adults aged eighteen or older with a mental disorder. This chapter discusses the vital role CBHOs play in providing both therapeutic and rehabilitative services to some of the nation's most vulnerable citizens. It outlines the origins of CBHOs within the publicly funded health care system in the United States, provides examples of available programs and services, and delineates the range of challenges faced by contemporary CBHOs as they strive to meet the needs of people with serious mental illnesses.

This chapter describes some ways that families who care for children with mental, emotional, or behavioral problems; youth who are served by the children's mental health system; and researchers, have collaborated in research and evaluation. Topics covered include historical development of consumer involvement in mental health research; a system of care evaluation in Clark County, Washington; family involvement in systems of care, the youth-driven research project, and evaluator perspectives on collaboration with family members.

The field of public health has a long, successful history of health promotion and disease prevention, including efforts relevant to mental health problems. Recent years have been marked by a dramatic increase in the development, implementation, and assessment of approaches to prevent the incidence of mental disorders. This chapter examines the rationale for prevention, the theories and methods that inform prevention science, the prevention strategies being employed across developmental stages and at multiple ecological levels, and emerging directions for the prevention field.

This chapter describes the mental health epidemiology and service delivery picture for 100 adults drawn at random from the American population. It also presents a description of the characteristics of mental health facilities, their services, available human resources, and aggregate revenues and costs. Unlike many other nations around the globe, America has no single mental health “system.” Rather, after years of starts and stops, US mental health care still consists of parallel activities operated by public and private entities across four care sectors. As a result, many individuals who need care do not receive it, and many who do receive care do not achieve the outcomes they are seeking.

This chapter weaves together reflections on two journeys, one quite public and the other more private. The public journey is the evolution of services for children with serious mental health problems in America over the past century and how the experience of one state — Connecticut — provides a more in-depth look at what has and has not occurred. The private journey is the evolution of the author's own thinking about children's mental health service systems, informed by her education as a clinical and community psychologist, her training in the world of public policy, her experience working in leadership positions in federal, state, and local settings over the past 20 years, and her most recent work in Connecticut. The chapter explores how these journeys have intertwined and what might be learned from each.

This chapter advances the development of successful partnerships between practitioners and researchers by (1) identifying the need for a two-way exchange of knowledge between practice and research; (2) highlighting the value of researcher-practitioner partnerships; (3) presenting an illustrative case study of one agency's successful work in this area; and (4) making recommendations for change.

This chapter presents the work of Partners for Success (PfS), a collaborative project between Smith College School for Social Work (SSW) and an urban public school system of a mid-size city in the Northeast. In a context of widespread experimentation in locating mental health services in the public schools, this program succeeded in achieving the goals of providing multi-systemic mental health services consistent with system-of-care principles, while preparing social work interns for clinical and leadership roles in school-based mental health services. The chapter describes the impetus for the project, the initial negotiations between the two partners, the agreed-upon goals, the initial stages of entry and engagement, a lengthy period of stability and expansion, the clinical model that evolved over time, evaluative studies of the degree of satisfaction experienced by different stakeholders, and the process of adjustment to recent financial crisis in the schools, with reduction in the scope of the program, coupled with integration into the structure of the school system. The story is supplemented by integrating discussions of important issues from the literature about school-based mental health practice, as well as with case examples.

This chapter argues that immigrants' need for mental health services can most effectively be met by community-based services that respect and integrate aspects of their culture of origin. The chapter includes three sections. First, unique characteristics of adolescent immigrants and their special needs are reviewed and illustrated. The second section reviews hallmarks of community-based practice, discusses and illustrates principles generated from successful community-based mental health services for adolescent immigrants, and argues why such services are better equipped than traditional services to meet their needs. The focus is on what proved helpful and how it can be done. Finally, the third section presents one example of a community-based mental health service.

This chapter describes the first community mental health center opened in Gjakova, Kosovo in 2001, following 10 years of conflict in the region from 1989 to 1999. The design and training for the services at the Gjakova Center for Mental Health grew out of an ongoing collaboration between U.S. and Kosovar mental health professionals, known as the Kosovar Family Professional Education Collaboration (KFPEC). Since 1999, the work of the KFPEC has supported the development of a family-focused community mental health system in Kosova, the center in Gjakova being the first of seven planned community mental health centers.

This chapter examines the role of country of origin in relation to psychiatric admission status in Ireland. Data presented in this chapter demonstrate that schizophrenia is a particular problem in individuals born outside Ireland and living in Dublin’s inner-city, and that this is associated with involuntary admission under the Mental Health Act 2001. The chapter also shows much lower levels of voluntary admissions. The chapter argues that these differences in patterns of help-seeking should be considered in future planning exercises in Ireland’s mental health services. In particular, increased emphasis on the cultural competence of health care-providers would be a good first step in recognising and addressing the differing health needs and practices of individuals from different ethnic groups and cultural backgrounds.

This chapter focuses on four key topics related to sexual orientation and mental health. First, it highlights several methodological issues that are relevant to understanding research on the associations between sexual orientation and mental health morbidity and its treatment. Second, it reviews findings from primarily population-based or systematically sampled surveys for evidence of sexual orientation-related disparities in mental health morbidity. The emphasis is on those studies that either included heterosexual comparison groups or used sophisticated research designs to minimize uncontrolled selection bias. Third, it presents preliminary findings from several population-based studies investigating sexual orientation-related differences in patterns of mental health services use. Finally, the chapter closes with some discussion of important future directions for research on sexual orientation and mental health, particularly in the context of large-scale population-based surveys.

This chapter considers how the Caplanian approach might in time become embedded in a whole school system committed to a child's wellbeing and resilient mental health. The first part outlines policy and practice proposals, and looks further at how this approach to primary prevention should be applied not only in state schools but in the context of private boarding schools as well. The second part considers its potential application in the context of child-related litigation in family courts. The third part touches on its relevance to child and adolescent mental health services, and argues for the development of a broader consultative preventive mental health approach to augment and complement their specialist therapeutic intervention.

Young adults face a number of stressful transitions that can prove a trigger point for their mental health, including the transition from school to work or university, leaving the family home, or managing relationships. This chapter looks at positive ways to improve transitional mental-health services for young people aged between 16 and 24, while acknowledging the financial constraints on the sector as a whole. By listening to young people and encouraging a person-centred approach, services can be developed to ensure useful and effective provision. The joint working agenda needs to be applied to this situation to encourage greater collaboration between children's and adults' mental-health services. Many young people arrive in mental-health services with a complex range of other issues. A holistic approach that looks at wider problems may help them to engage with a range of services and ease their transition out of child and adolescent mental-health services.