State of the Science Conference

March 6, 2007

View the Plenary Session introduction

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For Tuesday afternoon, the State of the Science sessions addressed what we know about the current realities of implementing effective systems of care. The Research and Training Center assembled a slate of experts who synthesized what we have learned within four key issue areas, and engaged participants in articulating future direction for the field.

Session 1 — Implementing Effective Systems of Care: What Have We Learned from the National Evaluation?

Handouts [312kb pdf]

Since 1993, there has been an ongoing national evaluation of the children’s mental health system of care grant program. This evaluation provides rich opportunities to learn not only about the overall effectiveness of the grants, but also about the actions taken by communities that have contributed to the development and implementation of effective systems of care. This session featured an introductory presentation by ORC/Macro, which has been a leader since the beginning of the evaluation, and was followed-up by presentations from a number of individuals from different perspectives who have been involved in the grant program.

  • Brigitte Manteuffel: Key issues on effective SOCs learned through the evaluation program
  • Holly Echo Hawk: Perspectives on site evaluation
  • Lisa Conlan: Perspectives on family involvement
  • Sylvia Fisher: CMHS perspective
  • Barbara Burns: Discussion/Implications

Session 2 — Conceptualizing and Measuring Systems of Care

Handouts [1.4mb pdf]

Since the system of care concept was introduced to the children’s mental health field, over 20 years ago, modifications have been made in the conceptualization of systems of care, in the understanding of what it takes to implement them effectively, and in the measurement of such systems. This session began with an examination of the changes in conceptualization that have taken place, and their implications for implementation and measurement of systems of care. The session then focused on several approaches to system of care measurement, and related them back to the changes in the conceptualization.

  • Bob Friedman: Introduces conceptual models for systems, and implications for measurement
  • Sharon Hodges: Study 2 holistic systems measurement
  • Paul Greenbaum: Study 1 national survey
  • Freda Brashears: SOC assessment
  • Bob Friedman: Discussion: How these measures relate to conceptual frameworks
  • Mike Agar and Steve Banks: Implications

Session 3 — More and Better Systems of Care: What are the Leverage Points?

Handouts [1.1mb pdf]

One of the challenges facing the children’s mental health field is how to build on the work of the past 20 years and develop more and better systems of care around the country for children with special mental health challenges and their families. This session focused on general strategies and leverage points for bringing about more pervasive and deeper changes in the children’s mental health field, based on what has been learned about implementing effective systems of care. The session included presentations from leaders in the field who represent multiple perspectives.

  • Gary Blau: Federal Policy perspective
  • Regenia Hicks: TA Partnership perspective
  • Paige Pierce: Family perspective
  • Myra Alfreds: Local perspective
  • Alfredo Aguirre: Local perspective
  • Beth Stroul: Implications and moderated discussion

Session 4 — Who Do We Serve? Lessons Learned about Defining the Population

Handouts [920kb pdf]

Systems of care have primarily been focused on supporting and assisting children with the most serious mental health challenges and their families. However, questions have been raised as to whether this continues to be the best approach, particularly in the long run, and suggestions have been made, for example, to enhance the focus on all children in need rather than those with the most serious challenges, or on young children in an effort to prevent the development of more serious problems. This session explored the short-term and long-term implications for policy, for research/evaluation and for design/implementation of how the field defines the population of concern, and examined lessons learned over the past 20 years.

  • Mario Hernandez & Teresa Nesman: Issues on defining the population of concern
  • Terry Cross: Tribal perspectives
  • Dane Cervine: Example of Population-based definition: Santa Cruz County
  • Karen Lofts-Jarboe: Another Example of population-based definition: Humboldt County
  • Knute Rotto: Indiana
  • Sandra Spencer: Discussion from family perspective