Communication service disturbances

Concerns that disproportionate numbers of children with serious emotional disturbance were being removed from their communities led to the development of systems of care in the 1980s. In 1992, Congress passed the Comprehensive Mental Health Services for Children and Their Families Program which supported the development of these systems of care. A system of care is in or near the home and community. In fiilly developed systems of care, local public and private organizations work in teams with families and children to both plan and implement individualized services for each child s physical, emotional, social, educational, and family needs. Teams include family advocates and representatives fi om mental health, health, education, child welfare, juvenile justice, vocational rehabilitation, recreation, substance abuse, and other services. Systems of care have supported the use of mental health clinicians in schools, school- and community-based wraparound planning and services, and student support services (Woodruff et al., 1999). 

This chapter focuses on children with extreme forms of psychopathology and very poor adaptive functioning. Many school and community mental health settings label this group of children as having serious emotional disturbance (sed) for purposes of funding and access to services, but there is variability in local or state criteria for sed. Common elements of sed definitions generally include the federal definition of the Individual with Disabilities Education Act (idea, 1997). As defined by Federal Law (cfr Parts 300 and 303) ... 

The IMHP model, now in its fifth year of operation, was developed through a public school-university collaboration to treat elementary school children (5-12 years old) with the most severe sed who (1) have extreme disturbances with emotional regulation (2) have severe deficiencies in behavioral control resulting in an inability to function in general or special education settings and (3) typically consume multiple social service, medical, therapeutic, and legal resources in the community (Vemberg, Njre, Roberts, 2000). 

The Center for Mental Health Services (1997) estimates that from 9 to 13% of all children aged 9-17 have a serious emotional disturbance that either impairs or substantially interferes with their ability to function effectively at home, school, or within the community. More than 20 years ago, Knitzer (1982) found that two-thirds of children in need did not receive mental health services. Since the publication of that landmark report, concerns about the small number of youth with mental disorders who receive mental health services have not lessened (Leaf, Bogrov, Webb, 1997 U.S. Department of Health and Human Services, 1999). Although recent research suggests that a greater proportion of children in need of mental services now receive them (Costello et al., 1993 Leaf et al., 1996), few communities can claim that all or even most youth identified as having mental or emotional problems receive effective services. 

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