Thursday, November 21, 2024
11/21/2024
Family Connections: A Community-Based Approach to Expanding Mental Health Access and Engagement for SED Youth system-of-care is intended to offset historic patterns of inequity in access to mental health care based on race and ethnicity, as well as to respond to the urgent mental health needs of migrant children and families who are arriving daily in Massachusetts' gateway communities in an effort to reduce the growing risk of youth suicide. Our proposed Family Connections system-of-care will include Cambridge Health Alliance’s primary care providers whom we will assist in launching broad-based screening of their adolescent patients for depression and substance use disorders. The Family Connections mobile team will be located in the community, but also onsite within CHA’s Family Medicine and Pediatric clinics in the towns of Cambridge, Somerville, Malden, Everett and Medford. This integrated care team will use a collaborative practice approach in primary care to support early identification of mental health needs and reduce time to treatment for SED youth. The team will actively collaborate with specialty mental health providers at CHA, also CBHCs providing 24/7 mobile crisis access, and CBOs providing non-traditional services, to improve treatment access and engagement. Culturally sensitive, peer-to-peer parent support specialists are a key ingredient for our Family Connections model, which involves uncovering barriers to care and developing individualized, family-driven remedies. Our target population is children 3-18 years old, including LGBTQ youth, with depression, trauma and/or SUD. Pre-pandemic data indicates Massachusetts had the highest rate of child abuse and neglect in the US during 2016 (DHHS, 2017). Approximately 25% of these children live below the federal poverty level (American Community Survey, 2011-2013). Before the surge in migration, the "gateway" cities we are especially targeting in Metro-Boston (Malden and Everett) had 2-3 times the rate of foreign-born residents (43% vs. 18%) compared to the rest of the MA, and twice the statewide rate of children whose parental language is not English (54% vs. 22.3%). CHA’s Children’s Health Initiative leadership will combine evidence-based interventions from its earlier MHSPY program (family support, care management and shared goals) with new strategies learned from our SafetyNet program, such as mobile (either face-to-face or telehealth) interdisciplinary child mental health evaluation teams, and intensive dyadic work with parent and child for multi-generational trauma. Clinical expertise will be combined with peer-to-peer parent/guardian support for trauma-informed care delivery to both parent and child. All aspects of the care continuum will be provided in a culturally and linguistically competent manner. We anticipate serving 200 children and families in total, at approximately 50 children per year. Program goals include: 1) Promote earlier recognition of child mental health needs to reduce risk of suicide; 2) Family-driven assessment approach to disrupt disparities and encourage treatment engagement; 3) Facilitate regional system of care, using SOC principles, and disseminate findings to state and local policy makers. Objectives: 1) Assess presence of SED (Serious Emotional Disturbance) via Standardized measures of Clinical Functioning (CGAS and CAFAS), 2) Screen for adverse childhood experiences (ACEs), depression and SUD, 3) Increase access to child mental health evaluation and treatment (Pre-post measures of patterns of service use for study participants and propensity-score weighted comparison group), 4) Improve family care experience, as measured by Family Professional Partnership Scale assessments, 5) Improve clinical functioning, including suicidal ideation, as measured by Baseline and follow-up CGAS and CAFAS assessments.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
