With over 50 million children and youth attending public schools in this country, these systems are a logical entry point for reaching children and their families (GIH 2008). Schools are major institutions in children’s lives, providing oversight for many hours of a typical weekday. Though health improvement is not the primary mission of the education sector, it has extensive influence in shaping children’s health and long-term development outcomes.
This comprehensive guide examines major trends in epidemiology, and assesses the treatment and cost of behavioral health care in the United States. It also analyzes the state of employer-sponsored behavioral health services and makes recommendations to improve the design, delivery and purchase of services.
SAMHSA's Financing Center of Excellence website features information about health care financing with a special focus on mental health and substance abuse. Using blog-style posts, this site offers original content and news, reports, briefs, scholarly article citations, legislation, and data sets regarding the financing of mental health and substance use treatment and prevention.
In 2008, FrameWorks began a multi-year study of American thinking about child and family mental health. Building on a decade of research on public perceptions of children’s issues, this research was designed to compare expert understanding with public patterns of thinking and to use framing research to close the conceptual gap. The full research design includes both qualitative and quantitative methods, documenting the dominant frames used to explain these issues in media and in expert discourse, as well as providing extensive documentation of how the public hears these communiques. The reports that follow document an evolving “core story” of child and family mental health, using framing techniques to plug the cognitive holes in lay understanding of this critical issue.
NH's mental health care system is under assault. The impacts of the broken system are seen in the stress it is putting on local law enforcement, hospital emergency rooms, the court system and county jails, and, most importantly, in the harm under-treated mental health conditions cause NH citizens and their families. This report is a compilation of research that examines children's mental health services for early childhood, school-age children, adolescents and young adults, and vulnerable populations.
New Hampshire has made great gains in supporting and bringing forward the voices of survivors -- those who have lost someone to suicide -- to understand and support them and reduce the isolation that often comes with their profound grief. This report outlines many successful efforts to educate the public, collect and analyze data and shape sound public policy that can help prevent suicide.
Young adults aged 18 - 24 are in a transitional period of life as they move out of adolescence and into adulthood. Although little research has been conducted on the psychological well-being of young adults, for most people this is a time of positive physical and metal health. However, for some young adults this is a period of great vulnerability and risk. This report examines prevalence of health care access, substance abuse, suicide and educational factors among this population and makes recommendations for improving the well-being of young adults in New Hampshire.
Mental health is a key component in a child's healthy development; children need to be healthy in order to learn, grow, and lead productive lives. The mental health service delivery system in its current state does not sufficiently meet the needs of children and youth, and most who are in need of mental health services are not able to access them. With the addition of effective treatments, services and supports, the mental health system can become better equipped to help children and youth with mental health problems, or those who are at risk, to thrive and live successfully.
Child Advocacy Centers (CACs) are community partnerships designed to coordinate multidisciplinary investigations of child abuse and other child victim crimes. The CAC team typically includes law enforcement, the County Attorney's Office, the Division for Children, Youth and Families (DCYF), victim advocacy agencies and the medical and mental health communities. This report summarizes an assessment to determine if the CACs can increase their capacity to link child abuse victims and their families to evidence-based mental health services.
This audit assessed the Bureau of Behavioral Health's (BBH) oversight of the community mental health system to ensure efficient and effective service provision. The audit period is State fiscal years 2008 and 2009. The BBH oversees community-based services by contracting with ten regional community mental health centers. In SFY 2009, the BBH expended $93.9 million for community mental health services. This total represents both federal and state funds. Approximately $1.3 million was spent on BBH administration. State funds are primarily used to reimburse the CMHCs for services to Medicaid recipients. The state no longer reimburses centers for non Medicaid consumers who cannot fully pay for services. Findings of the audit point to several areas in which the BBH can better align its operations with its current environment through planning, improved service oversight and risk mitigation.
This mid-theme review describes the Endowment's work to date and assess accomplishments, lessons, and future priorities. It is still early in the implementation of many of the foundation’s larger and multi-year grants that are focused on systems and services change. Therefore, evaluation data about impact are limited at this point. We expect to have more data about impact as implementation continues.
The New Hampshire Association for Infant
Mental Health is pleased to provide the following professional competencies related to early childhood and family mental health. These professional
competencies are intended to guide the preparation and ongoing professional development of service providers
in various fields who have a role in supporting families with young children.
The skills and knowledge necessary for promoting the social and emotional
development of children and for recognizing and addressing mental health issues are the purview of multiple
The mental health needs of children and families are becoming more and more complex, and there are increased demands on the system to implement evidence-supported practices, be more accountable for service provision and treatment outcomes, be more efficient, and shift from agency-driven treatment to family-centered, youth-driven care.
To meet these needs, the Children’s Directors from New Hampshire’s 10 community mental health centers are working together to develop and implement a set of core competencies designed to enhance the ability of the workforce to provide evidence-informed and best practices in children’s mental health.
The Disabilities Rights Center was asked by the Endowment for Health to conduct an analysis of available policy levers to support creation of a CME in New Hampshire. As part of that analysis, a review was conducted of other jurisdictions that have developed similar systems of care and have utilized CMEs to coordinate care for youth involved in multiple systems and with complex behavioral health needs.
The publication establishes the state's first documented plan for an integrated and comprehensive system of behavioral health care for our state's children and youth, presenting the action steps families, youth, leaders, professionals, and other stakeholders will take to achieve an effective System of Care for the next generation.
Adolescence is a critical period in the development of attitudes, behaviors, and life-style choices that can enhance health and well-being among young people. It is also a time of unique vulnerabilities, health issues, and real and perceived barriers to accessing health care. An important aspect of the Girls' Health Initiative was ascertaining not just what girls and young women do in regard to health-related behaviors, but more important, how they think about the choices they make and the meaning of their behaviors. In this report, our analyses integrate the voices of young women.
The NH Children’s Mental Health Focus Groups were convened by The National Alliance on Mental Illness NH (NAMI NH) in New Hampshire. The purpose of the project was to understand the thoughts of family and youth with mental illness as well as hear the observations and attitudes towards NH children’s mental health service system (public and private). This project provided us with important information as we planned the Endowment's new theme, Improving the Mental Health of NH's Children and Their Families. It also offered insight into the education and support needs of families dealing with a child and/or adolescent with mental illness.
This research aims to better understand the ways that scientists explain child mental health and the dominant patterns in how the public thinks and talks about this concept. The research with both these groups is designed to reveal specific areas where the understanding of scientists and that of the general public are dissonant -- where gaps or holes between these two groups exist in thinking and understanding the topic of child mental health. These missing links then represent promising areas for reframing strategies designed to close the gap between the scientific knowledge and the public's understanding of the policy implications of this knowledge.
As many as 55,756 children, ages 5 – 19 have a diagnosable mental health disorder and almost 14,000 have a serious emotional disturbance. Most of these children are educated in the New Hampshire public school system. Understanding if, and how, public schools manage the behavioral health issues of their students is of obvious public policy significance.
Despite this policy significance, comprehensive information about the role of schools in mental health services in New Hampshire is not available. This work – combining surveys of both school districts and schools and interviews with community mental health centers across the state – is designed to be an initial assessment of how this system is administered and funded, the mental health conditions driving this system, the services that it provides, and the manner in which the system assesses its progress in ensuring the mental well being of its children.
Early Childhood Mental Health is the social/emotional well being of children aged birth to six years, and promotes the capacity to experience, manage and express emotions; develop and sustain stable relationships with others; safely explore the environment and learn; and demonstrate developmentally appropriate behavior. This study examines the availability, accessibility and quality of early childhood mental health supports and services for New Hampshire's youngest children and their families.
This report examines the condition of the direct-service workforce in children's behavioral settings in New Hampshire. Many programs are under significant stress due to the tightening fiscal climate and changes to state policy that increasingly favors intensive in-home services over residential treatment for children diagnosed with mental, emotional and behavioral problems.
Staff in residential agencies report that they are working long and erratic schedules, and that their programs are understaffed and under-resourced. Despite their generally high educational levels, direct-service workers are poorly paid and some benefits, such as tuition reimbursement, are eroding. Weaknesses in the workforce are expensive for agencies and can affect client care. Yet it is likely that they will grow more crippling in the near future, as residential treatment becomes a last resort reserved for the most challenging young people. This report recommends a series of supports to bolster the direct-service workforce, and urges agencies to use this transition in services to craft creative solutions to workforce problems.
A number of national studies have shown that exposure to violence in the home, as well as direct abuse of a child, has a detrimental effect on children, with a wide range of responses, including long-term effects on mental health. This project was designed to develop regional and local strategies to improve the mental health outcomes of children and their families who are exposed to violence in their homes, as well as to identify ways to strengthen the systems of care.
Five listening sessions were held around New Hampshire in early 2009 to hear testimony and discuss the Ten-Year Mental Health Plan. That plan has outlined the impacts of the broken system and the stress it is putting on local law enforcement, hospital emergency rooms, the court system and county jails. Most importantly, under-treated mental health conditions cause harm to NH citizens and their families.
Policy makers, families and providers were invited to attend the sessions which brought forth some very moving testimony that demonstrated a need for a long-term commitment to improve and restore the mental health system in the state.
This report contains a description of the prevalence of co-occurring disorders among young Granite Staters, as well as the challenges facing them and their families, including barriers to accessing integrated, appropriate treatment and support. Drawing upon existing expertise in New Hampshire, the Project Advisory Group convened a Scientific Advisory Board comprised of leaders in the mental health, primary care and substance abuse treatment fields to make specific recommendations for implementing consistent, integrated treatment throughout the state.
In this MessageMemo, Frameworks Institute reports the findings from a series of studies that set out to: (1) document the cultural models available to ordinary people when they think about children's mental health, (2) observe these models in action as small groups of people negotiate conversations about child mental health, (3) identify the major challenges for communicating about these issues, and (4) develop, refine and test frame elements -- specifically, values and simplifying models -- that might deepen understanding of the core tenets of the science of child mental health, and evoke a more productive public discussion.
This paper is one of a series of reports commissioned to inform policy-makers about the status of mental health in New Hampshire. This analysis is designed to answer basic questions about the mental health status of New Hampshire’s children through an assessment of mental health prevalence estimates and an analysis of service use in the public Medicaid and privately insurance systems.
According to the 1999 U.S. Surgeon General report, one in five children has a diagnosable mental health disorder, and the vast majority of these youth – even those with the most severe impairments – receive no or inappropriate care. In New Hampshire, mental health practitioners have pointed to a shortage of providers, particularly child psychiatrists, as a primary cause of these unmet needs. These practitioners have described long waiting lists for appointments and the need for children living in rural areas to travel long distances for treatment. This paper provides an overview of the currently available data on mental health providers across the state.
Data on mental health service use is critical to understanding the system of mental health care for children. In addition, such data can provide a baseline against which policymakers can assess access to mental health services in light of prevalence estimates or future policy interventions designed to increase access to mental health services. This analysis assesses private insurance claims data, Medicaid data, and data on care provided to those without insurance from hospital discharge data and from the community mental health system. This report is one of a series of reports commissioned to inform policy-makers about the status of mental health in New Hampshire. This analysis is designed to answer basic questions about the mental health service system by analyzing the services that are being provided to those with mental illnesses.
This report is part of an investigation designed to inform the current knowledge base regarding evidence-based practices (EBPs) both nationally and in NH, the current status of EBP implementation in the state, and areas policy makers might consider as it supports improvements in access to EBPs in mental health services for New Hampshire children and adolescents. National literature on best practices and interviews with national and regional mental health experts serve as the basis for this report.
Suicide is the second-leading cause of death for New Hampshire's young people and is a major concern for citizens of all ages. The New Hampshire Suicide Prevention Council has compiled this annual report to assist professionals and the public to recognize the warning signs of suicide and to work collaboratively to intervene on behalf of those at risk.
The term Integrated Primary Care describes a clinical practice that integrates behavioral and medical health services within a primary healthcare setting...Rural areas, confronted with economic, geographic, and cultural barriers, face unique and significant challenges providing adequate mental health care...Behavioral health interventions hold promise for improving the diagnosis and treatment of mental disorders in the primary care setting, with strong evidence of effectiveness in improving patients' physical and mental health status.