Community and State Systems Change Associated with the Healthy Transitions Initiative

People engaged in efforts to improve services to emerging adults with serious mental health challenges have reached the conclusion that service change at the program or agency level is not sustainable without related changes at the systems or policy level. This article focuses on one set of efforts to create intentional system change at both the community and state levels. These changes were pursued by states and communities that received grants under the federally funded Healthy Transitions Initiative (HTI), with the aim of creating more effective services for emerging adults with serious mental health conditions. The article reviews the development of a measure to assess systems change efforts at the state and community levels and describes the findings that emerged when the measure was used to assess the change that occurred in the HTI sites over a period of approximately three and a half years

Under Construction: Linkages between Youth and Adult Systems after Expanding Transition Services

Summary: This report summarizes changes between 2003 and 2007 in relationships among organizations that offer services to individuals in transition to adulthood, ages 14‐25, who have serious mental health conditions in Clark County, Washington. In 2002 Clark County received a Partnerships for Youth Transition grant from the Center for Mental Health Services (CMHS), Division of Service and Systems Improvement, Child, Adolescent and Family Branch. The purpose of these grants was to plan, design, and implement programs to support the transition to adulthood for youth with serious mental health conditions up to age 25 and their families. Services for these youths span child and adult mental health service systems, and many different systems (e.g., vocational rehabilitation, substance abuse, education). Understanding how this vast array of services and systems interacted and changed over the course of the grant helps to identify whether such grants can positively impact the kinds of interactions that facilitate the process of transition for young people maturing into adulthood. While each locale has its own particular set of services, policies, and organizing forces, it is hoped that the findings in this county provide insight into systems in other sites. The primary audience for this report includes policy makers, state and regional administrators, program designers, and others interested in improving the network of services and supports for transition age youth (TAY) from mental health and other systems that TAY are involved with during their transition to adulthood. Others who may be interested in these findings include youth, family members, youth allies, and service providers

Where are Bridges Needed: Relationships Between Youth and Adult Services Before Strengthening the Transition System

Summary: This report summarizes the nature of the relationships between organizations and agencies in Clark County, WA, that could form a system of services to support youth and young adults with serious mental health conditions during the ages of the transition from adolescence to adulthood (ages 14‐25)

Focus on Function – a randomized controlled trial comparing two rehabilitation interventions for young children with cerebral palsy

<p>Abstract</p> <p>Background</p> <p>Children with cerebral palsy receive a variety of long-term physical and occupational therapy interventions to facilitate development and to enhance functional independence in movement, self-care, play, school activities and leisure. Considerable human and financial resources are directed at the "intervention" of the problems of cerebral palsy, although the available evidence supporting current interventions is inconclusive. A considerable degree of uncertainty remains about the appropriate therapeutic approaches to manage the habilitation of children with cerebral palsy. The primary objective of this project is to conduct a multi-site randomized clinical trial to evaluate the efficacy of a task/context-focused approach compared to a child-focused remediation approach in improving performance of functional tasks and mobility, increasing participation in everyday activities, and improving quality of life in children 12 months to 5 years of age who have cerebral palsy.</p> <p>Method/Design</p> <p>A multi-centred randomized controlled trial research design will be used. Children will be recruited from a representative sample of children attending publicly-funded regional children's rehabilitation centers serving children with disabilities in Ontario and Alberta in Canada. Target sample size is 220 children with cerebral palsy aged 12 months to 5 years at recruitment date. Therapists are randomly assigned to deliver either a context-focused approach or a child-focused approach. Children follow their therapist into their treatment arm. Outcomes will be evaluated at baseline, after 6 months of treatment and at a 3-month follow-up period. Outcomes represent the components of the International Classification of Functioning, Disability and Health, including body function and structure (range of motion), activities (performance of functional tasks, motor function), participation (involvement in formal and informal activities), and environment (parent perceptions of care, parental empowerment).</p> <p>Discussion</p> <p>This paper presents the background information, design and protocol for a randomized controlled trial comparing a task/context-focused approach to a child-focused remediation approach in improving functional outcomes for young children with cerebral palsy.</p> <p>Trial registration</p> <p>[clinical trial registration #: NCT00469872]</p

Behavioral characteristics associated with accidental poisoning in childhood

Two groups of parents from different socio-economic levels were questioned about the behavioral characteristics of their children before 18 months and subsequent incidences of accidental poisoning. The data collected showed proportional numbers of accidental poisonings regardless of parent education, race or income. Unusual activity in the child before 18 months was the best predictor of accidental poisoning during childhood

Changing the Rules: A Guide for Youth and Young Adults with Mental Health Conditions who Want to Change Policy

To some people, “policy” seems like a mysterious and perhaps boring topic, compared to the busyness and intensity of everyday life. However, a growing number of youth- and young adult-led groups have shown how policy issues can influence their choices and their lives in critical ways, and that they can have substantial influence on policy. Policies may be general, and apply to all people in society (e.g., traffic laws), or they may specifically focus on particular groups of people, such as people with a mental health condition or criminal record (e.g., policies about housing or employment). Organizations such as Youth M.O.V.E. and other groups led by young people with mental health concerns have demonstrated that they can have important roles in changing flawed policies to make them better or to put positive policies in place. Examples of policy issues that might need change include rules about eligibility for housing or rent subsidies; increased young adult choice in treatment; greater availability of peer services; or more services, supports, and funding for young people entering college, among others. This guide provides information about policy and policy change in mental health and other human services for young adult groups who want to be directly involved in policy change activities. Some of the many ways that young people can be involved in policy work include serving on advisory committees that consider areas where policy change is needed, participating on groups convened to review contract language about youth-related issues or serving on groups charged with developing rules and regulations to support recent policy change. A number of manuals or handbooks address these important roles, although few of them are specifically focused on mental health. This policy guide is written for youth- and young adult-led groups and organizations that want to make changes in policies that affect them and other transition-age youth. The intended audience for this guide is youth and young adults working together within a group or organization to make specific change, usually in partnership with other agencies, groups, or organizations. In fact, young adults who have been involved in successful policy change efforts often emphasize that their groups were able to accomplish their goals because they had supportive partnerships with other organizations

The Great Divide: How Mental Health Policy Fails Young Adults

Abstract: All individuals are challenged by the movement from being an adolescent living at home and attending school to being an adult typically heading a household and working to support him or herself. This period of time is called the transition to adulthood and is even more challenging for youth from vulnerable populations such as youth with disabilities, in foster care, in juvenile justice system, and the like (Osgood, Foster, Flanagan, & Ruth, 2005). The ages that transition encompasses have not gained consensus in research literature or policy. It begins at ages 14–16 in policies such as the Individuals with Disabilities Education Act (IDEA; PL101-476, 1997 and 2004 amendments) or Federal programs such as the Social Security Administration\u27s SSI Youth Transition Demonstration Projects, which identifies ages 22 and 25, respectively, as ending transition. Recent studies on young adulthood in the general population (Settersten, Frustenberg, & Rumbaut, 2005), found that by age 30, the rapid changes of young adulthood had typically stabilized. Thus, using the broadest ages indicated by policy and research, transition to stable adulthood encompasses ages 14–30

Advice to Young Adults from Young Adults: Helpful Hints for Policy Change in the Mental Health System

This tip sheet is designed for use by youth and young adult led organizations that include young people with lived experience in the mental health system in their membership. Organizations that have a history of working together collectively, have clear leadership roles and are ready to move into policy change are most likely to find these tips useful. The recommendations and the quotes contained in this tip sheet came from a series of interviews with young adult leaders from advocacy groups that focus on mental health challenges or living in foster care. Each organization was selected because of its work to change a policy that was important to its membership