Wednesday, May 6, 2009

54 Days Until the New Order in Children's Mental Health

Lots going on in the world these days, and returning from Baltimore has found me with a full desk and many details to which to attend.  The CSAs are really getting ready to roll out; people are establishing their main offices and developing their wraparound teams all over the state.  I have been speaking with several of the people involved in that process;  we will have a chance to talk with Jack Simons next week in Worcester (see the events calendar).   The most interesting part of the process, it seems to me, is how we are going to engage families in this paradigm.  I suspect that many will not want "strangers" in their home.  My experience with patients in Family Stabilization is that about 50% of the time decline services when push comes to shove.  How do you get past that, to give the intervention a chance to work?
Many families of children with serious emotional disturbance has lived for a while with the notion that they are to blame for their child's behavioral outbursts.  Won't they be concerned that, with a bunch of professionals in their home, that the Department of Children and Families will be there too?  That notion runs completely against the central tenets of wraparound.  Family engagement is at the center of the process and that engagement in general has to be voluntary.  One therapist with whom I spoke assured me that there services were going to be voluntary and that it would take a lot more than simple refusal of services to get a family reported to the Department.  The hope is that the Care Coordinators and the Parent Partners (still not approved by HHS) will be able to make this all happen.  Clearly, this work will require families and providers to rethink the paradigm.

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