1. ERIE COUNTY DEPARTMENT OF MENTAL HEALTH Children’s Behavioral Health

2. Summary Children’s mental health problems are real, common and treatable. Untreated mental health problems, including Severe Emotion Disturbance can disrupt children’s functioning at home, school and in the community. Without treatment, children with mental health issues are at increased risk of school failure, contact with the criminal justice system, dependence on social services, and even suicide. 2

3. Serious Emotional Disturbance Serious emotional disturbance means a child or adolescent has a designated mental illness diagnosis according to the most current Diagnostic and Statistical Manual of Mental Disorders (DSM) AND has experienced functional limitations due to emotional disturbance over the past 12 months on a continuous or intermittent basis. The functional limitations must be moderate in at least two of the following areas or severe in at least one of the following areas: (i) ability to care for self (e.g. personal hygiene; obtaining and eating food; dressing; avoiding injuries); or (ii) family life (e.g. capacity to live in a family or family like environment; relationships with parents or substitute parents, siblings and other relatives; behavior in family setting); or (iii) social relationships (e.g. establishing and maintaining friendships; interpersonal interactions with peers, neighbors and other adults; social skills; compliance with social norms; play and appropriate use of leisure time); or (iv) self-direction/self-control (e.g. ability to sustain focused attention for a long enough period of time to permit completion of age-appropriate tasks; behavioral self-control; appropriate judgment and value systems; decision-making ability); or (v) ability to learn (e.g. school achievement and attendance; receptive and expressive language; relationships with teachers; behavior in school). 3

4. Youth Substance Dependence & Abuse Substance abuse and problematic patterns of substance use among youth can lead to problems at school, cause or aggravate physical and mental health-related issues, promote poor peer relationships, cause motor-vehicle accidents, and place stress on the family. They can also develop into lifelong issues such as substance dependence, chronic health problems, and social and financial consequences 4

5. Clinic Treatment Mental Health Clinics Free-standing Satellite clinics in Schools Satellite clinics in Pediatrician’s Offices Substance Abuse Clinics 5

6. Children’s System of Care Single Point of Access Home and Community Based Waiver Services to disrupt the trajectory towards detention and out of home placements such as: Family Voices Network for Care Coordination Monitoring Urgent Access CARES – Crisis and Re-stabilization Emergency Services Supportive Care Coordination Family Keys 6

7. Locally Implemented Evidence Based Practices Trauma Informed Care Care Coordination Multi-System Therapy (MST) Cognitive Behavioral Therapy (CBT) Brief Strategic Family Therapy (BSFT) Prevention- Strengthening Families Program (as an example) 7

8. Positive Outcomes All contracted services are required to use a “practice to outcome” model For youth in Care Coordination, documented improvement in clinical status at discharge Youth referred to the Children’s System of Care have decrease out-of-home placements Despite marked increased out-of-home placements for the community at large, the level of placements for juvenile justice youth involved in Children System of Care Community Services youth remain consistently low 8

9. Positive Outcome Data Youth and their Families in services stay in the community Third Quarter 2014 outcomes for Wraparound/Family Voices Network 80% were discharged without an event associated with risk of deeper system penetration such an arrest 95% did not have a psychiatric admission 95% did not have a Residential Treatment admission Juvenile Justice Community Diversion Services 84% were discharged without an event associated with risk of deeper system penetration such an arrest 85% sustained their community living status 9

10. Partnerships Say Yes Emerging Health Homes County Department of Social Services and Probation Managed Care Technical Assistance Center/Coordinated Care Services, Inc. 10