News

State, Advocates & MCOs Commit to a Children's Call for Change

June 5, 2009

Does it make sense to talk about improving the public children’s behavioral health system in the midst of our country’s economic down turn? Yes, now more than ever it is critical that what we fund results in healthy outcomes for children.

That is what state staff, family advocates, and Managed Care Organization (MCO) representatives agreed on during the April 28 & 29, 2009 retreat. The retreat was led by the head of PA Office of Mental Health and Substance Abuse (OHMSAS), Deputy Secretary Joan Erney and the OHMSAS Children’s Bureau Director, Stanley Mrozowski.  

The Way it Was

Both Joan and Stan have been committed to children’s system reform for decades. They set the tone for the discussion by reviewing the early beginnings of behavioral health services for children in PA in the 1980's. In the 1980’s children and adolescents had very little service options, most services were the same for adults and children, and often provided by the same clinicians. Children could receive office visits and psychiatric hospitalization. If they needed more, families had to give up custody and children were placed in residential centers under Child Welfare. For children with the highest need, there were two psychiatric state hospitals where children were locked up for long periods. 

State and Community Partnership Highlighted

Family Advocacy organizations represented were the Mental Health Association in PA, Moms Tell, Disabilities Rights Network and PA Families Inc.  Every Behavioral Health MCO attended.  These MCOs are responsible to oversee the public behavioral health system in PA and report to counties and the state.  County children’s mental health coordinators and administrators were also in attendance.

Everyone agreed that:

• Pennsylvania now leads the nation in the number of children served and the amount of dollars spent. 
• The array of services that is currently available is much closer to what we need for children and their families than what we started with in the mid 1980s, though there are still problems with the accessibility and quality of services.
• Accompanying this huge growth of services are practices that are often designed as a one size fits all. The system design does not allow enough time to individualize care with time for planning, supervision and measurement of outcomes.
• Services need to be more flexible, more evidence based, and there needs to be more support and information for families.

Next Steps- Children’s Call for Change

OMHSAS staff has committed to issuing the conclusions and recommendations from the retreat for broader public input.  They have also committed to providing leadership for the strategic planning which will follow this larger review. The work will fall under the title "Children’s Call for Change" and is expected to mirror the groundbreaking work on a similar initiative for adults begun earlier under Joan’s leadership. See more about the adult “A Call for Change” at http://parecovery.org/principles_change.shtml