An Innovative Public Health Approach to Promoting Positive Outcomes

 

Community Based Children and Family Mental Health Services Research Program: An Innovative Public Health Approach to Promoting Positive Outcomes

Supporting children and adolescents with resources for mental health has never been more essential. An estimated 7.7 million children in the U.S. have a mental health disorder, and only half of these youth have received proper treatment. Children in urban communities are at a higher risk for and less likely to get the help they need, leading to devastating health outcomes.

Left untreated, mental health difficulties for children are linked to long-term negative outcomes such as academic failure and behavior problems, substance abuse, involvement in the juvenile justice system, and many other life barriers, all of which come at a tremendous cost to them as well as their families.

Dr Marc Atkins“Years of research have shown our mental health systems are failing our children, especially not providing the support for families in high poverty urban communities. The current system can be best described as a ‘wait to fail system’ where we wait for children to do badly, then step in with services that aren’t appropriate to meet the needs of the children, especially in high poverty areas. We know that the problem is not the children, but instead the problem is a society that’s not providing the support they need,” says Dr. Marc Atkins, Director of the Community Based Children and Family Mental Health Services Research Program (CBCFMHS) within UIC’s Department of Psychiatry’s Institute for Juvenile Research (IJR).

The CBCFMHS primary goal is to conduct research that promotes effective and sustainable mental health services to support the prevention, early intervention, and treatment of urban children's mental health difficulties. The program is focused on training teachers to use classroom-based interventions for disruptive students, supporting staff in after-school and recreational setting to promote mental health, and building and supporting community-based workforces.

Over the last 15 years the program has refined an innovative public health approach that uses resources inherent in natural community settings to achieve mental health aims alongside social, emotional, recreational, and educational goals, which highlights the long-term investment needed to engage in community collaboration and partnership to advance mental health services research.

CBCFMHS work closely with an extensive network of public agencies to ensure that the work has real world significance, including projects with the Chicago Park District, the Chicago Public Schools, and Chicago Department of Public Health, and nonprofit social service agencies in schools and after school programs.

Closing the mental health service gap by addressing ecological factors

The specialty mental health sector, including community mental health, has been under-funded for decades. Only 1 in 4 children with mental health difficulties will receive services, and the barriers to care for marginalized communities create an even bigger divide in the services use disparities. 

“It’s not reasonable to ask schools to manage children’s mental health without this support. We need to rethink our approach to children’s mental health by breaking down the silos that artificially separate in schools. It’s imperative that the onus be taken off schools in order to administer the most effective treatment possible,” says Dr. Atkins.

CBCFMHS research is rooted in utilizing Dissemination and Implementation Science (DI) principles and, focusing on the ecological factors that impact child and family mental health/wellbeing to explore and how evidence-based interventions can be successfully adopted and implemented in mental health care delivery and community settings.

DI has evolved as a major research model for children’s mental health in response to a longstanding call to integrate science and practice and bridge the elusive research to practice gap.

To address the complex and urgent needs of the most vulnerable children and families, future directions for DI require a new alignment of ecological theory and public health to provide effective, sustainable, and accessible mental health services.

The challenge of addressing our nation’s mental health burden can be met by supporting the needs and values of families and communities within their own unique social ecologies. CBCFMHS focuses on embedding DI within natural settings to build on local capacity and existing resources, thereby incorporating the local knowledge necessary to more substantively address long-standing mental health disparities.

Addressing children’s mental health need in diversified communities

Despite national attention and long-standing calls for the increase of children’s mental health services in urban communities, disparities remain in mental health care for racial and ethnic minority youth. Black, Latino, Native American and Asian communities have been disproportionately affected by medical disinvestment.

Dr Dana RuschCommunity collaboration and cultural relevancy are at the core of CBCFMHS’s research and methodology. The success and adaptability of CBCFMHS offerings are evident in programs such as the Immigrant Family Mental Health Advocacy (IFMHA) Program, created by Dr. Rusch, Assistant Professor of Clinical Psychiatry at UIC and member of the CBCFMHS team. The IFMHA Program is a research-practice-policy hub designed to support the mental health of immigrant communities through ecologically informed clinical services, community-engaged research, and advocacy and policy efforts at the local, state and national level. 

The deportation and forced separation of children of immigrant families arriving to the United States has psychological effects on individuals and families and gives rise to a public health crisis that affect entire communities. “There is a vast literature documenting the negative impact of the sociopolitical climate on the daily experiences of children from immigrant and refugee families. Rapidly changing policies create a context of uncertainty, which challenges family coping and resilience. Bridging the research to policy gap is an essential part of supporting communities and advocating for change,” says Dr. Rusch.

An already overwhelmed urban school system has been additionally burdened as the de facto mental health system for children, which is not only bound to fail but also unsustainable without considerable investment in changing the way that we support schools, communities, and families.

Developing solution-driven initiatives is the trademark characteristic of the CBCFMHS. The program provides adaptive alternatives to the current system of mental health services that enhances sustainable setting-specific goals and processes in the communities where these diverse youth live.

Reimagining intervention models to increase sustainable mental health services 

IJR/CBCFMHS’s community-based programming has proven to be exceptionally impactful; its success is driven by innovative research and methodology at the intersection of practice, policy and advocacy that provide marginalized communities with restorative mental health support. 

Dr Tara Mehta“Our aim is to transform the field of children’s mental health services by developing service models that are based on community-driven solutions and evidence-based practice that is tailored to the unique needs, strengths and goals of the communities we serve. We also believe that community capacity building and equitable partnerships that focus on social determinants of mental health and the structural inequity that disproportionately impacts our Chicago communities will be critical to promoting the mental health of underserved children and families,” says Dr. Tara G. Mehta, Associate Professor of Clinical Psychology at UIC and member of the CBCFMHS research team.

Cultural relevancy is a key ingredient to facilitate efforts, but policy and advocacy efforts among community stakeholders will be needed to reinvest in prevention and to bring research/data to bare on policy decisions, resource allocation, and infrastructure, to ultimately improve child and adolescent mental health.

 

Marc Atkins PhD

  • Professor of Psychiatry and Psychology
  • Director, Institute for Juvenile Research
  • Director, Community Engagement and Collaboration
  • Center for Clinical Translational Science

Tara G. Mehta PhD

  • Associate Professor of Clinical Psychology
  • Director of Psychology Training

Dana Rusch PhD

  • Assistant Professor in Clinical Psychiatry
  • University of Illinois at Chicago
  • Institute for Juvenile Research, Department of Psychiatry
  • Director, Immigrant Family Mental Health Advocacy Program

 

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