Abstract
Building on the President's New Freedom Commission on Mental Health, this article highlights the twofold crisis in children's mental health: a critical shortage of practitioners in child-serving disciplines, and a mismatch between training and preparation and actual practice and service delivery. The authors discuss the challenges of transforming the workforce in the context of changing population demographics, the prevalence of complex childhood disorders, and emerging evidence-based practices. The authors conclude with recommendations targeted to states, community agencies, universities, professional associations, and advocates.
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REFERENCES
American Academy of Child Adolescent Psychiatry. (2001). Report of the AACAP Task Force on Work Force Needs: Meeting the mental health needs of children and adolescents: Addressing the problems of access to care. Washington, DC: American Academy of Child and Adolescent Psychiatry, Department of Government Affairs.
Casey Foundation. (2003). The unsolved challenge of system reform: The condition of the frontline human services workforce. Baltimore, MD: The Annie E. Casey Foundation.
Clausen, J., Landsverk, J., Granger, W., Chadwick, D., & Litrownik, A. (1998). Mental health problems of children in foster care. Journal of Child and Family Studies, 7, 283–296.
Coalition for Juvenile Justice. (2002). Handle with care: Serving the mental health needs of young offenders. Washington, DC: Coalition for Juvenile Justice.
Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care, Vol. 1. Washington, DC: Georgetown University National Technical Assistance Center for Children's Mental Health.
Decker, M. C., Koot, H. M., van der Ende, J., & Verhulst, F.C. (2002). Emotional and behavioral problems in children and adolescents with and without intellectual disability. Journal of Child Psychology and Psychiatry, 43(8), 1087–1098.
Duchnowski, A., Kutash, K., & Friedman, R. (2002). Community-based interventions in a system of care and outcomes framework. In B. Burns, & K. Hoagwood (Eds.), Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders. New York: Oxford University Press.
Dykens, E. M. (2000). Psychopathology in children with intellectual disability. Journal of Child Psychology and Psychiatry, 41(4), 407–417.
Dykens, E. M. (2003). Anxiety, fears, and phobias in persons with Williams syndrome. Developmental Neuropsychology, 23(1-2), 291–316.
Einfield, S. L., & Tonge, B. J. (1996). Population prevalence of psychopathology in children and adolescents with intellectual disability: II. Epidemiological findings. Journal of Intellectual Disability Research, 40, 99–109.
Emerson, E. (2003). Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability. Journal of Intellectual Disability Research, 47(1), 51–58.
England, M. (1997). Training the existing workforce. Administration and Policy in Mental Health, 25, 23–26.
English, M. (2002). Policy implications relevant to implementing evidence-based treatment. In B. Burns & K. Hoagwood (Eds.), Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders. New York: Oxford University Press.
Friedman, R. (2000). At the core competency project of the workgroup on training and education of the American Academy of Child and Adolescent Psychiatry. Washington, DC: American Academy of Child and Adolescent Psychiatry.
Friedman, R., Katz-Leavey, J., Manderscheid, R. & Sondheimer, D. (1998). Prevalence of serious emotional disturbance: An update. In R. Manderscheid, & M. Henderson (Eds.), Mental health, United States (pp. 110–112). Rockville, MD: USDHHS, Substance Abuse and Mental Health Services Administration.
Friedman, R., Kutash, K., & Duchnowski, A. (1996). The population of concern: Defining the issues. In B. A. Stroul (Ed.), Children's mental health: Creating systems of care in a changing society (pp. 69–89). Baltimore: Paul H. Brookes.
Garland, A., Hough, R., McCabe, K., Yeh, M., Wood, P., & Aarons, G. (2001). Prevalence of psychiatric disorders in youth across five sectors of care. Journal of the American Academy of Child and Adolescent Psychiatry, 40(4), 409–418.
Goode, T., & Jackson, V. (2003). Getting started. moving on. planning, implementing, and evaluating culturally & linguistically competent systems of care for children and youth needing mental health services and their families. Washington, DC: National Center for Cultural Competence, Georgetown University Center for Child and Human Development.
Goode, T., Jones, W., & Jackson, V. (2002). A guide to planning and implementing cultural competence: Organizational self-assessment. Washington, DC: National Center for Cultural Competence, Georgetown University Center for Child and Human Development.
Government Accounting Office. (1995). Child welfare: Complex needs strain capacity to provide services. Washington, DC: GAO/HEHS-95-208.
Government Accounting Office. (2003). HHS could play a greater role in helping child welfare agencies recruit and retain staff. Washington, DC: GAO 03–357.
Halfon, N., Medonca, A., & Berkowitz, G. (1995). Health status of children in foster care: The experience of the Center for the Vulnerable Child. Archives of Pediatric and Adolescent Medicine, 149, 386–392.
Hansen, M. (2002). The need for competencies in children's public mental health services: A CASSP discussion paper of the Pennsylvania CASSP training and technical assistance institute. John Wiley & Sons.
Hansen, M., Anderson, C., Gary, S., Harbaugh, M., Lindblan-Goldber, & Marsh, D. (1996). Child, family and community core competencies, rev. ed. Harrisburg, PA: Pennsylvania Child and Adolescent Service System Program Training and Technical Assistance Institute.
Hoagwood, K., Burns, B., & Weiss, J. (2002). A profitable conjunction: From science to services in children's mental health. In B. Burns, & K. Hoagwood (Eds.), Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders. New York: Oxford University Press.
Hoge, M., Huey, L., & O'Connell, M. (2003). Best practices in behavioral health workforce education & training. Concept paper for the May 2004 Annapolis Coalition Conference on Behavioral Health Workforce Competencies.
Holden, W., & Santiago, R. (2002). Substance use among children and youth referred to systems of care. Rockville, MD: US DHHS, Substance Abuse and Mental Health Services Administration.
Huey, L. (2002). Problems in behavioral health care: Leap-frogging the status quo. Administration and Policy in Mental Health, 29, 403–417.
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st Century. Washington, DC: National Academy Press.
Jellinek, M., Patel, B. P., & Froehle, M. C. (Eds.) (2002). Bright futures in practice: Mental health, Vol. I, practice guide. Arlington, VA: National Center for Education in Maternal and Child Health.
Lavigne, J., Gibbons, R., Christoffe, K., Arend, R., Rosenbaum, D., Binns, H., Dawson, N., Sobel, H., & Isaacs, C. (1996). Prevalence rates and correlates of psychiatric disorders among preschool children. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 205–214.
Lyons, J., Baerger, D., Quigley, J., & Griffin, E. (2001). Mental health service needs of juvenile offenders: A comparison of detention, incarceration, and treatment settings. Children's Services: Social Policy, Research, and Practice, 4(2), 69–85.
Manderscheid, R. W., & Henderson, M. J. (in press). Mental health practitioners and trainees. In Mental health, United States, 2002 (pp. 332–373). Rockville, MD: USDHHS, Substance Abuse and Mental Health Services Administration.
McRee, T., Dower, C., Brigganee, B., Vance, J., Keane, D., & O'Neil, E. (2003). The mental health workforce: Who's meeting California's needs? San Francisco, CA: University of California at San Francisco Center for Health Professions.
Meyers, J., Kaufman, M., & Goldman, S. (1999). Promising practices: Training strategies for serving children with serious emotional disturbance and their families in a system of care. In Systems of care: Promising practices in children's mental health(Vol. V). Washington, DC: Center for Effective Collaboration and Practice, American Institutes for Research.
Morris, J., & Hanley, J. (2001). Human resource development: A critical gap in child mental health reform. Administration and Policy in Mental Health, 28, 219–227.
Morris, J., & Stuart, G. (2002). Training and education needs of consumers, families, and front-line staff in behavioral health practice. Administration and Public Policy in Mental Health, 29, 377–402.
National Advisory Mental Health Council (NAMHC) Work group on Child Adolescent Mental Health Intervention Development and Deployment. (2001). Blueprint for change: Research on child and adolescent mental health. Rockville, MD: National Institute of Mental Health.
New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America, final report. Rockville, MD: DHHS Pub. No. SMA-03-3832.
Pires S. (2002). Building systems of care: A primer. Washington, DC: National Technical Assistance Center for Children's Mental Health Georgetown University Child Development Center.
Pires, S. (1996). Human resource development. In B. A. Stroul (Ed.), Creating systems of care in a changing society (pp. 281–297). Baltimore, MD: Paul H. Brookes.
Poertner, J., & Teste, M. F. (2004). Race matters in child welfare: The over representation of African-American children in the system. Washington, DC: Child Welfare League of America.
Pottick, K. (2002). Children's use of mental health services doubles, new research-policy partnership reports. In Update: Latest findings in children's mental health. New Brunswick, NJ: Institute for Health, Health Care Policy, and Aging Research, Rutgers University.
Pottick, K. J., & Warner, L. A. (2002). More than 115,000 disadvantaged preschoolers receive mental health services. In Update: Latest findings in children's mental health. New Brunswick, NJ: Institute for Health, Health Care Policy, and Aging Research, Rutgers University.
Regier, D., Farmer, M., Rae, D., Locke, B., Keith, S., & Judd, L. (1990). Comorbidity of mental disorders with alcohol and other drug abuse: Results from the epidemiological catchment area (ECA) study. Journal of the American Medical Association, 264(19), 2511–2518.
Sarason, S. (1972). The creation of settings and future societies. San Francisco, CA: Jossey Bass.
Sickmund, M., & Snyder, H. N. (1999). Juvenile offenders and victims: 1999 national report. Washington, DC: Office of Juvenile Justice and Delinquency Prevention.
Stuart, G., Hoge, M., & Tondora, J. (2004). Theory and evidence-based teaching strategies: Implications for behavioral health. Concept paper for the May 2004 Annapolis Coalition Conference on Behavioral Health Workforce Competencies
Teplin, L., Abram, K., McClelland, G., Duncan, M., & Mericle, A. (2002). Psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry, 59(2), 1133–1143.
Trader-Leigh, K. (2002). Building cultural competence: A tool kit for workforce development. Washington, DC: The Joint Center for Political and Economic Studies.
Trends in the well-being of America's children youth. (2002). Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services.
U.S. Bureau of Health Professions. (2000). Health professions shortage areas index. Available: http:// bhpr.hrsa.gov/shortage/index.htm.
U.S. Department of Health Human and Services (1999). Mental health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
U.S. Department of Health Human and Services. (2001). Mental health: Culture, race, and ethnicity, a supplement to mental health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General.
Warner, L., & Pottick, K. (2004). More than 380,000 children diagnosed with multiple mental health problems. In Latest findings in children's mental health. New Brunswick, NJ: Institute for Health, Health Care Policy, and Aging Research, Rutgers University.
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Huang, L., Macbeth, G., Dodge, J. et al. Transforming the Workforce in Children's Mental Health. Adm Policy Ment Health 32, 167–187 (2004). https://doi.org/10.1023/B:APIH.0000042745.64582.72
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DOI: https://doi.org/10.1023/B:APIH.0000042745.64582.72