This Web site is a component of the SAMHSA Health Information Network
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This Web site is a component of the SAMHSA Health Information Network |
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This Web site is a component of the SAMHSA Health Information Network. |
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1999 Annual Report to Congress on the Evaluation
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CHAPTER SUMMARY In summary, other CMHS-funded activities in support of the grant projects included:
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To support and enhance the Comprehensive Community Mental Health Services for Children and Their Families Program, the Child, Adolescent and Family Branch of CMHS initiated several activities during FY 1999 and expanded upon others. The following section summarizes these initiatives and their FY 1999 accomplishments.
The National Resource Network for Child and Family Mental Health (NRN) is a national technical assistance center whose primary mission is to mobilize training and technical assistance to help CMHS grant communities achieve their service system development goals. The Washington Business Group on Health (WBGH), of which NRN is a part, has a cooperative agreement with the Child, Adolescent and Family Branch of the CMHS, SAMHSA. Additional funding is provided by the Administration for Children, Youth and Families; the Office of Special Education Programs; and the Office of Juvenile Justice and Delinquency Prevention. WBGH, in partnership with the Child, Adolescent and Family Branch, provides leadership and guidance to the NRN, which also supports the Branch in implementing the grant program.
The NRN has a home office in Washington, D.C., and three field offices, or hubs. Grant communities are assigned to either the urban, small city or county, or rural hub, depending on their characteristics. Each hub is led by a hub director, who works with the grant communities to carry out a variety of hub technical assistance activities, including hub meetings, conference calls among grant communities, peer consultations, cross-hub trainings, and others. Hub directors also provide individual consultation and strategic planning assistance to grant communities to help them assess grant community needs, develop a technical assistance plan, and engage technical assistance expertise through the NRN.
The NRN publishes a biannual newsletter, and in FY 1999 began operation of an NRN Web site with pertinent information for grant communities, their interagency partners, and others. NRN staff coordinate closely with other national mental health technical assistance centers, sharing information and resources and informing grant communities of relevant materials and opportunities.
To promote interagency, family-focused planning and implementation at all levels of the grant projects, the NRN hired seasoned advisors in education, child welfare, and juvenile justice, and teamed with senior family consultants through a contract with the Federation of Families for Children's Mental Health. These experts provide targeted consultation and technical assistance to individual grant communities and participate in cross-site and national training activities.
One key NRN role is to collaborate with the Child, Adolescent and Family Branch to organize and lead national and hub meetings each year, which bring together grant communities to learn, share, and support one another in their work. Major meetings held in FY 1999 are discussed below.
Each year, the NRN coordinates two national meetings for teams from the grant communities. These meetings bring together key professionals, family members, and site evaluators for 4 days of training, sharing, networking, and learning. Also invited are program partners, government representatives, and other national technical assistance centers and collaborators. The grantee meetings provide grant communities with opportunities to develop a common sense of goals and purpose, to deepen their understanding of what goes into building effective community-based systems of care, and to receive guidance with some of the day-to-day problems as well as the long-term challenges they face in implementing their project plans. Grant communities are encouraged to invite local education, child welfare, and juvenile justice representatives to strengthen interagency collaboration efforts.
The Fall Grantee Meeting was held in the Phoenix area in November 1998, with 335 people in attendance. The conference theme was Treatment Interventions in a System of Care: Innovations, Models and Technologies. Sessions focused on what was occurring at grant communities at the practice level: changes in practices, integration of culturally relevant approaches to healing into systems of care, emerging treatment innovations, and responses to challenges to effective practice. Sessions were led primarily by representatives from grant communities, with some co-facilitation by program consultants and outside experts. Pre-conference activities included a Technical Assistance Day for Families, a cross-system discussion on evaluation, an education forum, and a forum for Native American grant communities. New activities introduced at this meeting included an exhibit area for grant communities to display and share materials and information, a Welcome Center staffed by CMHS personnel, and a dinner honoring the graduating grant communities.
In May 1999, the Spring Grantee Meeting was held in Arlington, Virginia, with 477 people attending. The meeting highlighted the new seven-volume Promising Practices series of monographs sharing knowledge gained from the first 5 years of the grant program. Concurrent sessions on lessons learned by the grant communities were led by grant communities highlighted in the Lessons Learned volume of the series. The Promising Practices Institutes featured presentations by the authors of the other six volumes in the series, as well as sessions on evaluation. The meeting included several peer-to-peer discussions on topical issues and sessions on "special focus" priority issues such as building in accountability and preventing youth violence.
From November 30 through December 2, 1998, the NRN coordinated a meeting in Arlington, Virginia, for the 14 newest grant communities. The agenda was designed to familiarize new grant leaders, family members, and interagency partners with the mission and values of the CMHS grant program; to introduce them to the resources available to help them successfully build and sustain their systems of care; and to walk them through program and evaluation requirements and procedures. Opportunities were provided for grant community teams to meet one another and begin developing supportive networks, both within hubs and among the group as a whole. One hundred forty people attended the orientation meeting.
Hub meetings enable grant communities from across the country to come together to share their learnings; develop a supportive network among one another; and gain new insights, energy, and a renewed sense of purpose. Hub meetings generally address topical issues that have emerged as priorities among grant communities, as well as provide forums for peer-to-peer technical assistance and networking.
In FY 1999, the urban hub met in January. The meeting focused on Strategies for Success with Juvenile Justice and the Child Welfare System: How Does the System of Care Address the Issues of Race and Class? The small city or county hub met in February 1999, addressing three major content areas: the role of families in the system of care, what it takes to make it work, and education as a partner in the system of care. The small city or county hub met again in July 1999, with the focus topic being Child Welfare Partnership in the System of Care. In May 1999, the rural hub met with the aim being to "give sites an opportunity to learn from one another, create site-to-site information exchanges, and strengthen the sense of team."
A special 1-day meeting was held in Rockville, Maryland, in April 1999 on The Adoption and Safe Families Act: Exploring the Opportunity for Collaboration between Child Mental Health and Child Welfare Systems. Invited grant communities brought teams of child welfare, child mental health, and family organizations to hold a dialogue on implementing the Adoption and Safe Families Act (ASFA) and improving cross-system collaboration to benefit children and families who come in contact with the child welfare system. A total of 50 people participated in the meeting. Resource people and grant community representatives led sessions on the implementation, impact, and challenges of ASFA from various perspectives. Participants worked in small breakout groups to address the challenges and to plan potential collaborative opportunities between child mental health, child welfare systems, and families in regards to ASFA implementation.
The Committee on Improving Practice was organized following the Fall (1998) Grantee Meeting to work on increasing the NRN's capacity to develop and disseminate technical assistance resources targeted to evaluating and strengthening front-line clinical practice. The committee is comprised of clinicians and family members from grant communities, as well as invited resource people, WBGH president Mary Jane England, and senior staff from the NRN and the Federation of Families for Children's Mental Health. The first committee meeting, Focus on Practice, was held in April 1999 in Washington, D.C., with 29 in attendance. Committee members participated in discussions of the efficacy of particular technical assistance products and strategies, working toward creation of a "menu" of evidence-based technical assistance tools. The committee produced a set of recommended clinical technical assistance topics and products to develop, which are now under consideration.
Due to the unique characteristics and needs of Native American grant projects, the Native American hub was formed in 1997. This fourth hub is led by the National Indian Child Welfare Association (NICWA), which works in partnership with the NRN to orchestrate technical assistance efforts for Native American grant communities, currently numbering five. The Native American hub director, in close collaboration with the NRN, conducts site visits, coordinates grant community strategic planning efforts, provides support and individual consultation, and links grant communities to technical assistance experts and resources.
In FY 1999, the Native American hub hosted two hub meetings. The first was in Portland, Oregon, in December. The meeting covered a number of issues central to project implementation, including strategic planning, family involvement, and financing. In addition, presentations were given by speakers from the Child, Adolescent and Family Branch, from the national evaluation team at ORC Macro, and from the social marketing campaign, with ample opportunity for questions and discussion. The Native American hub also met in Maine in May. The first day was spent at a grant community, the Passamaquoddy Nation's Kmihqitahasultipon Program, meeting with program staff, community members, partners, consultants, and local artists. The next 2 days were centered around presentations on priority issues facing grant communities as they work on building their systems of care, including the Individuals with Disabilities Act (IDEA), juvenile justice, and Medicaid.
The social marketing campaign, Caring for Every Child's Mental Health: Communities Together, uses customer-centered strategies to help the grant communities increase community understanding of children's and adolescents' mental health needs and to garner support for attention to this issue. Site-based research and information-gathering activities ensure that products developed for this initiative directly reflect grant communities' needs and are sensitive to the populations served. CMHS recently funded a second 5-year contract with Vanguard Communications to continue the campaign. Under the new contract, the scope of the campaign has been broadened to include outreach to communities beyond the grant communities.
Working together with its two subcontractors, the National Mental Health Association and the Federation of Families for Children's Mental Health, Vanguard Communications distributed campaign materials, including brochures, posters, fact sheets, articles, and public service announcements, throughout FY 1999. New products included a Spanish-language poster and brochure about children's mental health, and a guide for families written in English and Spanish, developed under the leadership of the Federation of Families for Children's Mental Health.
The social marketing campaign provides technical assistance to grant communities upon request, helping them make the best use of campaign tools and strategies, and responds to information and material requests from both grant communities and the general public through its toll-free telephone number. Campaign representatives made presentations at the twice-yearly grantee meetings sponsored by CMHS and at the three technical assistance meetings held for potential applicants to the new round of grants, and attended other multi-site grantee meetings.
Through a contract from the NRN, the Federation of Families for Children's Mental Health provides technical assistance and support to the NRN and the grant communities to help ensure full family participation in all aspects of planning, implementation, evaluation, and sustainability. Working closely with the NRN central staff and hub directors, the Federation is involved in planning at the national and hub levels, has input into grantee and hub meetings, and contributes to NRN products and resources. Federation staff team with the NRN to conduct new grant community assessments and serve on site visit teams.
Since the inception of the grant program, the Federation has provided direct technical assistance to grant communities that request consultation on family involvement. Technical assistance providers have included both staff from the Federation's central office and State and local experts. As of early FY 1999, a field team of four family consultants had been trained to handle technical assistance requests concerning family issues, which are received at the Federation office and triaged to the most appropriate consultant. The family consultants provide both telephone and on-site technical assistance, based on grant community needs and available resources.
Forty-seven professionals and 45 family leaders from grant communities participated in this important new initiative launched to help community leaders successfully lead, create, and sustain change in the comprehensive, community-based, system-of-care environment. The Leadership Academy, developed and led by COMMUNITIES CAN! at the Georgetown University Child Development Center, held two intensive, 42-day sessions, in November 1998 and January 1999.
Considerable effort went into designing and testing the innovative Leadership Academy curriculum. Sessions included a variety of interactive, individual, and didactic activities to help participants understand and build upon their personal leadership capacity as they strive to meet the challenges of developing effective systems of care in their communities. Participants underwent a self-assessment process using normed scales, and undertook reading and writing exercises prior to the Academy; they continue to be involved in post-Academy work to assist them in achieving their leadership goals and moving their communities forward.
The response from the Leadership Academies has been resoundingly positive. Participants felt energized, motivated, and better prepared to undertake the tasks they face as leaders of the grant projects. Many reported that their participation in the Academy made a distinct difference in how they viewed themselves as leaders and in their overall effectiveness in their leadership roles.
In January 1999, the Child, Adolescent and Family Branch, in conjunction with the Annie E. Casey Foundation and the National Technical Assistance Center for Children's Mental Health at Georgetown University, began planning the Urban Initiative. Based on the premise that developing and sustaining comprehensive local systems of care in large urban centers requires unique skills and strategies that may not apply in other environments, the Urban Initiative will undertake a series of activities focused on gathering and sharing lessons learned from the CMHS urban grants and from the four sites funded by the Casey Foundation through its Urban Mental Health Initiative.
An Urban Initiative Advisory Committee of 20 members with diverse perspectives was selected, primarily from the CMHS and Casey Urban Mental Health grant sites, and convened in July 1999. Also invited were Federal staff, national technical assistance providers, and grant program partners. The Advisory Committee recommended potential activities and products for the Urban Initiative. These are currently being considered, with an FY 2000 Urban Initiative agenda expected soon.
Four technical assistance meetings were held in early 1999 for communities,
Native American tribes, and Alaskan Native communities interested in applying
for the upcoming round of Comprehensive Community Mental Health Services
for Children and Their Families Program grants. The meetings, held in
Washington, D.C., and Denver, provided prospective applicants with information
and guidance to help them understand and effectively address the program
goals and the various components of the grant application.
A key focus of the meetings was ensuring that attendees fully grasped
the concepts of community-based systems of care and the importance of
applying those concepts to their project designs. To deliver this message,
teams from several funded projects discussed their planning and implementation
process. These discussions gave participants the opportunity to learn
from those most directly involved in building systems of care through
the CMHS grant program.
The 1½-day meetings also included sessions addressing family involvement,
cultural competence, financing issues, and interagency partnerships. Staff
from the Child, Adolescent and Family Branch walked participants through
the grant application process. Another presentation addressed the "nuts
and bolts" of preparing a successful Federal grant application. Overviews
of the national evaluation and the social marketing campaign were provided,
with a discussion of grant communities' roles in these efforts. The final
hours of the meeting were designed to provide attendees with brief consultation
sessions with meeting presenters. Applicant teams and individuals received
individualized guidance on issues of their own choosing.
A total of 89 individuals representing 46 communities, Native American
tribes, and Alaskan Native communities attended the technical assistance
meetings. A meeting transcript was available upon request to those who
were unable to participate in the meetings. Responses from participants
indicated that they found the meetings very worthwhile and that it provided
the types of information they were seeking to help them better understand
the grant program and design their projects.
In January 1999, a 2-day meeting was held for applicants who submitted
grant proposals for the Comprehensive Community Mental Health Services
for Children and Their Families Program but were not funded. The purpose
of the meeting was to provide technical assistance to small community
delegations around building community-based systems of care for children
with emotional disorders and their families. Fifty-five individuals attended
as members of delegations from 18 unfunded communities, along with a number
of Federal staff and guest participants.
The meeting was planned and led by the National Technical Assistance Center
for Children's Mental Health at Georgetown University. Expertise was also
provided by resource consultants from the Child, Adolescent and Family
Branch; the National Resource Network for Child and Family Mental Health
Services; and the Federation of Families for Children's Mental Health;
and by peer experts from grant communities.
Over the 2 days, participants assessed their current systems of care, learned about different implementation strategies, addressed particular problems in their grant applications, and developed action steps to enhance system development efforts in their communities and, perhaps, reapply for grant funding in the future. The meeting included both plenary sessions and individualized technical assistance with each delegation to work on community-specific issues. Participant evaluations of the meeting were uniformly positive, with especially high praise for the individual technical assistance opportunities.
A major achievement of FY 1999 was the publication of the first seven monographs of the Promising Practices Initiative of the Comprehensive Community Mental Health Services for Children and Their Families Program. Through this series of papers, Promising Practices: Systems of Care for Children with Serious Emotional Disturbances and Their Families in the United States of America, CMHS is making available the learnings of the first 5 years of the grant program to communities, agencies, and families throughout the entire country. The purpose of sharing these findings is to add to the national knowledge base information on how best to support and serve children with serious emotional disturbance and their families, with the hope that others will benefit from the grant communities' experiences.
The information comprising the Promising Practices series was largely gathered from the original 22 program grant communities. Research was conducted through site visits, focus groups, the national program evaluation, and professional and parent interviews. Data collection methodologies were purposely designed to be family driven, community based, culturally relevant, and inclusive.
The 1998 Promising Practices series contains the following titles:
I. New Roles for Families in Systems of Care
II. Promising Practices in Family-Provider Collaboration
III. The Role of Education in a System of Care: Effectively
Serving Children with Emotional or Behavioral Disorders
IV. Promising Practices in Wraparound
V. Promising Practices: Training Strategies for Serving
Children with Serious Emotional Disturbance and Their Families in
a System of Care
VI. Promising Practices: Building Collaboration in
Systems of Care
VII. A Compilation of Lessons Learned from the 22 Grantees
of the 1997 Comprehensive Community Mental Health Services for Children
and Their Families Program
There has been great demand for the Promising Practices monographs. Over 2,700 full sets have been distributed, along with over 1,000 of each individual volume. Orders through SAMHSA's National Mental Health Information Center continue on a regular basis. A number of additional titles on other relevant topics are now underway and will be published in FY 2000.
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