Highlights from Youth Mental Health Policy Forum: “Building a True System of Care”

On January 8th, Lincoln Child Center in Oakland, Calif., hosted a mental health policy forum aimed at developing state and federal legislative proposals for improving mental health services for families and youth in California. The forum featured a panel of legislators, policy makers, agency leaders and mental health advocates. Panelists highlighted challenges and opportunities for building a more coordinated system of care for youth with mental health needs.

A dizzying number of programs and funding sources make up the children’s mental health service “system,” including child welfare, mental health, education, juvenile justice and probation. Each agency has its own mission, organizational culture, institutional procedures, eligibility rules and funding streams. Young people and their families must navigate this foggy labyrinth of programs and policies amid difficult circumstances. This challenge can feel insurmountable, leaving many youth and families frustrated, “lost in the cracks,” and without adequate care.

As panelist Elizabeth Estes, education attorney and founder of Breaking Barriers, put it: “Sometimes we [as a system] function as divorced parents. We have the same children but we don’t serve them together.” A trauma survivor herself, Estes described “seeing the trauma inflicted by our siloed system” on her young clients and their families. Families seek services in one system only to be told time and again: “We don’t have that service…try that other system.” Estes understands this challenge both professionally and personally. When she was a college student, she found herself the victim of a violent situation. “I was able to find the intensive services I needed. I think about the youth and families who haven’t every day.”

Panelist Patrick Gardner, president of Young Minds Advocacy, said even when we do provide services, “we often ignore what we’re asking of youth and families.” To illustrate, Gardner shared a story of one family who had several young children involved in multiple systems. The result: a total of 35 treatment goals, 45 monthly meetings, and 26 helpers. Unsurprisingly, the family couldn’t keep up, and was deemed “noncompliant.”

“We set these families up to fail, even as we throw resources at them,” Gardner said.

While it’s easy to point fingers, the panelists agreed that looking for whom to blame only widens the chasm between systems and won’t lead to improved outcomes for youth and families. “We are all complicit in this,” said Gardner. “All of us have a role to play in determining how we can do better.”

So what are some solutions? Panelists emphasized opportunities in the next legislative session for improving the system of care for youth and families in California.

Here are some highlights:

  1. Addressing the mental health aspect of Continuum of Care Reform (CCR): In October, California passed AB 403 or Continuum of Care Reform, which will phase out long-term group home placements for youth in foster care. The goal is to help ensure youth grow up in permanent and supportive homes. However, the new law doesn’t adequately address how this shift will affect the delivery of mental health services. Youth placed in group homes are more likely to have a mental health condition, and often need more intensive services compared to foster youth in other placement settings. As part of CCR, we have to ensure that all youth, especially those with the highest needs, have access to quality home and community-based mental health care.
  2. Fixing the “out-of-county, out-of-network” problem: California runs on a county-based mental health system. When foster youth are moved across county lines, they often find themselves “out-of-network” and “out-of-luck” when it comes to receiving mental health services. An estimated one in five foster youth in the state are moved across county lines, meaning as many as 12,000 youth in need of mental health services experience delays in their care or are denied it altogether. AB 1299, which was originally introduced last year by Assemblymember Sebastian Ridley-Thomas (D), aims to fix this issue.
  3. Providing school-based early intervention mental health services:  Panelist Assemblymember Rob Bonta (D) is sponsoring AB 1644. The bill seeks to provide school-based intensive mental health services for youth who have experienced severe trauma.

These bills and other policy shifts are promising opportunities for California to build a more coordinated mental health delivery system for children and youth. But as panelist Assemblymember Tony Thurmond (D) said, the question is whether “we can put our money where our mouth is, and get kids access to services wherever they sit.”

In order to implement solutions that actually improve lives, it’s also imperative that we, as a system, do a better job of listening to and partnering with youth and families. As panelist Sinead Anderson, a youth advocate with lived experience, explained, “the empowerment piece is lacking in services.” She highlighted the importance of supporting community-based programs like Youth In Mind, which teach youth how to be effective advocates for themselves and their communities.

“Advocacy is the best therapy,” said Anderson.

Annabelle Gardner is Director of Communications at Young Minds Advocacy.

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Young Minds Advocacy is a nonprofit organization based in San Francisco, California that uses strategic advocacy and communications to help youths and their families to access mental health services and supports, and improve mental health system performance and accountability.