October 2006

Many of the children in our system of care have both emotional and physical health care needs, yet there often seems to be little communication between the mental health and physical health service providers in our community. How can we make sure that the youth in our community are getting diagnosed and treated holistically?

In order to create better linkages between the primary care and mental health care systems, it is crucial that individuals and organizations within communities advocate for change. Many times, however, it can feel as though our voices are unheard or unheeded. One of the most powerful ways to is to increase our effectiveness as advocates is to build coalitions. There is strength in numbers and in diverse representation; both of these can provide powerful tools for systems change.

To create the most effective coalition, it is important to reach out beyond the system of care’s traditional partner organizations to provider organizations that may be outside of our comfort zone. These include Federal initiatives such as the Maternal and Child Health Bureau’s Medical Home projects, which target children with special physical, emotional, and behavioral health needs, as well as private organizations such as the American Academy of Pediatrics and the Medical Society. Working with School-Based Health Centers that provide comprehensive or mental health care, other community-based organizations and volunteers can both help get efforts off the ground and enact longer-lasting changes. A broad base of ideas, opinions, and expertise is more important than size. This will help create a more diverse, community-based approach to defining the problem.

Steps to Building Coalitions

Forming a coalition sounds easy, but proper planning and knowledge can avoid future problems. Here are some suggested steps for putting together a coalition.

1. Define your objectives and needs

Why are you forming this coalition and what goals need to be accomplished? What is the scope of interest and influence? For instance, will the coalition tackle a state-wide issue or a local issue? How big should the coalition be? Is the coalition intended to solve a short-term finite problem or will the coalition be in place for the long term? When, where, and how often will the coalition meet? Is the mission or guiding purpose for the coalition clear?

2. Gather adequate resources

Ensure that staff time is available to build and coordinate the coalition.

3. Identify potential members

Identify who is already doing work in child and adolescent health and mental health. Create a diverse list of individuals and groups that are stakeholders in your key issue. Seek representatives from all sectors so that the coalition reflects the community. Go outside your comfort zone.

Get the ball rolling

Invite individuals and representatives of the chosen organizations to join the coalition. Be sure to include information about who else is invited, how the coalition will function, and what will be expected of them as a coalition partner. Consider joining one of the member’s coalitions.

5. Set up the coalition’s first meeting to develop an action plan

Develop strategies, activities, and tactics for accomplishing the coalition’s goals for improving school health. Formulate an agenda for achieving next steps. Determine what resources each partner brings to the coalition.

6. Establish an identity for the coalition

Prepare the coalition’s statement of purpose or mission statement and ask members to endorse it.  

7. Follow up with coalition members and potential members

Send a follow-up letter to meeting attendees thanking them for their interest. Inform members of the next activity and the progress of the coalition. You can also use existing newsletters and local newpapers to thank members for their efforts and advertise upcomming meetings or events. 

8. Develop coalition materials

Consider creating a member contact list, fact sheets, and/or meeting briefs for distribution.

9. Keep the ball moving

Be sure to maintain momentum and interest around your issue. Follow up with participants and keep them posted on progress or action.

10. Keep the lines of communication open

Do not overwhelm coalition participants with too much information, too many meetings, or unrealistic expectations. Be sure to check in periodically with coalition partners to make sure that they feel they are benefiting from their affiliation with the coalition. Encourage feedback and suggestions from participants.

 

Ensuring the Success of Your Coalition Clarify the exact purpose of the coalition. Allow time for buy-in to ensure that the group maintains interest and stays involved. Choose a strong leader to maintain focus. Provide training for contact with the media, public speaking, etc. Provide sufficient funding or secure financial commitment from the agencies involved. Keep moving forward despite the unwillingness of key groups to become involved. Make sure that someone is accountable for the work of the coalition. Problems are best solved when participants try to communicate and listen

 

Working with Other Organizations

• While your own organization can have significant influence on policies, funding priorities and other issues sometimes there is strength in numbers. Consider partnering with other local organizations. Do not just stop at the local level. Did you know that there are state and national organizations interested in these issues? Often, these associations can have the influence necessary to enact change at various levels of government. Such organizations include:
• The Federation of Families for Children’s Mental Health
• Family Voices
• The American Academy of Pediatrics, including the Medical Home (AAP)
• The AAP state and local chapters (for information on State and local chapters see www.aap.org)
• The State Maternal and Child Health Directors (contact information is found on the Maternal and Child Health Bureau/Health Resources and Services web site: https://perfdata.hrsa.gov/MCHB/MCHReports/link/state_links.asp)
• The American Medical Association and State and local Medical Societies (www.ama-assn.org)
• The American Academy of Child and Adolescent Psychiatry (www.aacap.org/index.ww)
• The National Mental Health Association (www.nmha.org)
• The National Association of State Mental Health Program Directors (www.nasmhpd.org/)
• The National Association of Community Health Centers, Inc. (www.nachc.com/)
• The State Medicaid agencies, Directors and staff (www.cms.gov) and the National Association of State Medicaid Directors (www.nasmd.org/)
• Can you think of anyone else

It is important to remember that improving the life and health of our children and youth not only depends upon providing services to individuals and families, but also in effecting changes for the better in the environment in which they live.