Objective D: Assure that children and youth receive integrated, individualized mental health services appropriate for their needs in the least restrictive setting through collaboration within the Department of Health and Social Services.

Discussion

The Department of Health and Social Services has increased integration of planning and problem-solving regarding services provided by the Department. Current areas of focus include:

· Supporting those children and youth in the Department's custody and their families.

· Developing regional and local solutions to support children and youth in need of mental health and substance abuse services. The divisions of Mental Health and Developmental Disabilities and Alcohol and Drug Abuse are coordinating closely with the Division of Family and Youth Services to develop new ways to provide mental health and substance abuse services to children and youth in custody.

· Evaluating the Alaska Youth Initiative.

· Identifying systemic inefficiencies that limit access and timely provision of services, and developing recommendations to improve the delivery of individualized services to severely emotionally disturbed youth.

· Establishing Department policy regarding the screening of youth at risk of placement into treatment facilities in other states and monitoring of those placements. Over forty children and youth, and youth in state custody, are currently in out-of-state residential facilities. Close monitoring of these cases and screening of potential new referrals will ensure that all local options have been reviewed and will provide information about service needs in Alaska. The Department can then more closely identify what residential treatment needs exist, and whether there are specialized service needs that cannot be feasibly provided in Alaska.

The Department should continue to strive toward establishing a seamless system of service delivery for children and youth with mental and emotional disorders by integrating services within the department and by collaborating with other stakeholders. These efforts need to involve families, planning boards, consumer advocacy groups, and providers. Barriers to services and barriers that create fragmentation of services need to be eliminated. Collaboration will avoid duplication of services and help assure cost effective services.

Actions

18. Identify resources to support comprehensive, integrated mental health services for seriously emotionally disturbed children and youth including crisis respite and residential alternatives to institutional care.
Responsible party: Division of Mental Health and Developmental Disabilities

19. The Alaska Mental Health Board and Division of Mental Health and Developmental Disabilities will develop a strategic plan to assure reduction in barriers to mental heath services for children and youth at risk of placement into state custody and their families, including examining the possibility of giving priority to mental health treatment of abused children and youth, children and youth who have witnessed violence, and children and youth of substance abusing parents.
Responsible party: Division of Mental Health and Developmental Disabilities

20. The Department of Health and Social Services will develop a plan and assure funding for providing seamless services for children and youth with serious emotional disturbance who receive services from more than one agency within DHSS.
Responsible party: Department of Health and Social Services

21. Review Department of Health and Social Services' structures, plans, and service delivery to identify ways to enhance coordination and integration of service delivery, including: mental health and substance abuse services; mental health and social services; and Department of Health and Social Services physical and mental health services. Whenever possible, such public health services as Early Periodic Screening Diagnosis, and Treatment and maternal and child health services, should provide a focus on behavioral and emotional health and identification and early intervention.
Responsible party: Task group

22. The Division of Mental Health and Developmental Disabilities and Division of Alcoholism and Drug Abuse will identify barriers to simultaneous services for children and youth with mental and emotional disorders and co-occurring substance abuse problems and eliminate those barriers to simultaneous care.
Responsible party: Division of Mental Health and Developmental Disabilities, Division of Alcoholism and Drug Abuse

23. Assure careful input by advocates and mental health professionals into the development of regulations for secure and semi-secure treatment facilities licensed by the Division of Family and Youth Services. Program data should be reviewed by an intra-departmental and Alaska Mental Health Board workgroup to assure appropriate use of secure and semi-secure treatment facilities.
Responsible party: Division of Family and Youth Services

24. The Alaska Mental Health Board will use research findings from the Center for Mental Health Services, National Institute of Mental Health and other multidisciplinary research sources to plan for Alaska's children.
Responsible party: Alaska Mental Health Board

25. The Alaska Mental Health Board will invite the Director of Division of Family and Youth Services to sit ex officio on the Board.
Responsible party: Alaska Mental Health Board