What is a “System of Care?”

Key Principles/Values
of a System of Care

Characteristics of Children with Serious Emotional Disturbances

Slide 4

Systems of Care as
Changing, Evolving Entities

Slide 6

Program designers “never expect to arrive at a steady state of programming because they’re constantly tinkering as participants, conditions, learnings, and context change. They don’t aspire to arrive at a model subject to summative evaluation and generalization. Rather, they aspire to continuous progress, ongoing adaptation, and rapid responsiveness…”

“Collectively, the results of the evaluations of systems of care suggest that they are effective in achieving important system improvements, such as reducing use of residential placements, and out-of-state placements, and in achieving improvements in functional behavior…

…There are also indications that parents are more satisfied in systems of care than in more traditional service delivery systems…

…The effect of systems of care on cost is not yet clear, however. Nor has it yet been demonstrated that services delivered within a system of care will result in better clinical outcomes …There is clearly a need for more attention to be paid to the relationship between changes at the system level and changes at the practice level .”

Important National Evaluation
Comprehensive Community Mental Health Services Program for Children and
Their Families

Theory of Change

Case Study Findings


“We should recognize the importance of research and evaluation “that trace backward from the experiences, behavior, perceptions, and status of service recipients”

“…the problem-solving ability of complex systems depends not on hierarchical control but on maximizing discretion at the point where the problem is most immediate.”

Applicability of Evidence Based Interventions to Systems of Care

Mental Health System



Systems of Care and
Evidence Based Interventions