Children and Adolescents

Improve access to and coordination of mental health services.

Administrative Measures

• The President should issue an executive order establishing an interagency body to foster greater coordination, and collaboration and joint financing, across the numerous federal programs with responsibilities for, or related to, children's mental health. Its focus should be on developing systems-collaboration in the delivery of community-based mental health services. The order should require the pertinent agencies to coordinate their respective efforts, beginning with development of overarching, common policy goals, operational plans, and common outcome measures. The order should direct the agencies to revise rules that impede furthering policy goals and seek legislative change, if necessary, to overcome those barriers.
  
  
• The President should issue an executive order encouraging greater coordination and collaboration between, and joint financing of existing Federal programs, to promote mental health screening and early intervention and treatment through the schools with the stated aims of averting development of serious emotional disorders, improving academic performance, preventing youth violence, and meeting the range of treatment needs of schoolchildren.
  
  
• CMS should establish policy to ensure that states fully use Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services.

Legislative Measures

• Establish a program to support the establishment and provision of integrated services as alternatives to out of-home placement of children with mental or emotional disorders. Administered by SAMHSA (in consultation with the Office of Juvenile Justice and Delinquency Prevention, Department of Education, and other pertinent agencies within HHS), the program would provide for planning and "front-end" funds to states and communities to develop and implement new financing mechanisms to establish and operate comprehensive home- and community-based services and supports to children with mental or emotional disorders and their families.
  
  Grantees would need to demonstrate a plan for sustaining service capacity through the pooling of funds from multiple systems (or otherwise redeploying and linking different funding sources).
  
  
• Authorize the Department of Education, in consultation with the Substance Abuse and Mental Health Services Administration, to make grants to states, other units of government, and private nonprofit organizations to support the provision (in schools and other educational settings) of (1) screening and other assessments; (2) early intervention, crisis intervention, and mental health services to children with, or at risk of, mental, emotional or behavioral disorders; and (3) professional development and training of staff. Grant applicants must demonstrate broad collaboration of parents and all relevant local agencies and organizations in the application for, and administration of, a grant.
  
  
• Establish a five-year matching-grant program in SAMHSA, in consultation with the Health Resources and Services Administration, to assist community health centers to provide mental health screening for pre-school children in primary care settings, and provide referral services to - or early intervention services in collaboration with - community mental health centers and other appropriate providers. The program would employ appropriate screening tools to assess at-risk children otherwise eligible for care by community health centers, and would encourage formal linkages between those centers and community mental health centers (or other appropriate providers) to assure continuity of care.
  
  
• Require explicitly that grantees under the Comprehensive Community Mental Health Services for Children's Program provide integrated services to address co-occurring mental health and addiction disorders.

Treatment for youth in or at risk of contact with the juvenile justice systems.

Administrative Measure

• The Department of Education and other relevant federal agencies should issue guidelines, similar to those recently released by the Office of National Drug Control Policy, that urge school administrators to treat and counsel high school students who are disruptive or use drugs and show signs or symptoms of mental or emotional disorder, rather than suspending, expelling, or turning them over to juvenile courts without treatment.

Legislative Measure

• Provide grants that would ensure mental health screening for all juveniles entering the juvenile justice system, followed by, if appropriate, diversion and treatment. [See Mental Health Juvenile Justice Act (H.R. 2198 and S. 1965)].