October, 2002

Success Story of a Sustainable Program: The Child Welfare Diagnostic and Evaluation Unit (D&E) of the Jefferson County Community Partnership

Background

The Jefferson County Community Partnership (JCCP) in Alabama has been a funded System of Care community since 1997 and soon will graduate. However, its Diagnostic and Evaluation units (D&E) will continue beyond the federal grant period because of the buy-in they have built on the basis of their successful relationships with the child welfare, education, and juvenile justice agencies in Birmingham, Alabama.

The 1993 Multiple Needs Child Law was passed by the Alabama State Legislature to establish monthly case review or "facilitation team" meetings in each Alabama county for "multiple needs children" (children with a mental health diagnosis who are in need of the services of two or more child-serving agencies and are at high risk for out-of-home placement). Due to strong interagency relationships, Jefferson County's facilitation team was voluntarily established several years prior to the passing of this legislation and was instrumental in the winning of the Jefferson County Community Partnership grant.

The success of JCCP’s D&E units has as much to do with JCCP’s relationship with the local child welfare, juvenile justice, and education agencies as it does with the structure of the D&E units and their mission.

JCCP’s Innovation

What makes this program so special? It established units at key entry points within the service system for youth who are considered at risk. It involved parents in the diagnosis and intake interviews. And the program worked to enhance, expand, and develop mental health services with the participation of the Department of Human Resources (DHR) in Birmingham, as well as the juvenile justice and education agencies.

Although JCCP was receiving referrals from DHR and was involved in interagency contracts with a local juvenile court judge before 1998, there was still a need to better address the needs of youth considered at risk.

The first D&E unit was established in August 1998. JCCP’s research identified a high need for mental health diagnostic/evaluation services to address specific city and county students considered to be at greater than normal risk for out-of-school and out-of-home placement. The research provided evidence that a higher than normal number of special education students classified as “emotional conflict” had been suspended or expelled for student code and discipline violations. These students also had higher than normal truancy rates and showed a disturbing trend for higher than average dropout rates by grade 8. By grade 9, these youth considered at risk had a higher than normal rate of involvement with the local juvenile court authorities. As in many other municipalities across the nation, the waiting list for outpatient psychological services was lengthy.

Goals and Functions of the D & E Units

The D& E units were designed with the following objectives:

  • Identify children and adolescents who were appropriate and eligible for mental health services, but who had not been previously identified or had not received services that adequately met their mental health needs.
  • Enhance and expand child and adolescent mental health services available within the targeted community of Jefferson County
  • Develop flexible services that address the unique challenges of children and adolescents with serious emotional disturbance (SED) and their families.
  • Increase access to these services and move the youth and their families through the system of care in such a way that facilitates service utilization and coordination across agencies.
  • Empower families to take a more active and decisive role in the assessment, planning, and coordination of their children’s mental health services.

The overall goals of the D&E units are to complete a timely assessment and, in conjunction with the family, to develop an individualized service plan. The evaluation procedures are standardized throughout all sites to prevent the duplication of services. The addition of the parent advocate at each unit location ensures that the offered services will be family focused.

Each D&E unit is staffed with a Master’s level mental health professional, a board certified child and adolescent psychiatrist, case managers, and a parent advocate who is a graduate of the JCCP services. Unit staff screen all referrals for eligibility; assess for the least restrictive and most appropriate mental health service needs; develop an individualized service plan that includes input from the parent(s), the child, the school, and mental health and all other agencies involved or anticipated to have possible future involvement; and coordinate and access appropriate mental health and related social services from the continuum of care. Unit staff work with the direct assistance of the mental health case manager, parent advocates, and other available community supports.

In addition, the units’ mental health professionals are either directly providing or accessing services on behalf of the target population along a continuum of care that includes

  • assessment and service coordination/planning;
  • mental health consultation to teachers, other school personnel, probation officers, and social workers;
  • assistance in developing school-based functional behavior management plans;
  • in-service training for teachers, students and parents regarding mental health issues;
  • linkage to services within the target community;
  • promotion of family education, involvement, and support groups;
  • mental health assessments for children referred to the court/detention center D&E unit; and
  • determination of current mental health needs and the least restrictive and appropriate interventions for those children referred to the D&E unit at the DHR.

Family Involvement

In addition to effective interagency collaboration, the JCCP has been successful at integrating families into the system of care and empowering them to take a more active and decisive role in the assessment, planning, and coordination of their children’s mental health services. Family representatives were involved with the formation of the JCCP and are active in all parts of its functioning, from family representation on the Coordinating Council to parent/family advocates and family members employed by the JCCP.