The all too common exposure of young children to traumatic situations and the life-long consequences that can result underscore the need for effective, developmentally appropriate interventions that address complex trauma. This paper describes Head Start Trauma Smart (HSTS), an early education/mental health cross-systems partnership designed to work within the child’s natural setting—in this case, Head Start classrooms. The goal of HSTS is to decrease the stress of chronic trauma, foster age-appropriate social and cognitive development, and create an integrated, trauma-informed culture for young children, parents, and staff. Created from a community perspective, the HSTS program emphasizes tools and skills that can be applied in everyday settings, thereby providing resources to address current and future trauma. Program evaluation findings indicate preliminary support for both the need for identification and intervention and the potential to positively impact key outcomes.

Medical shared decision making has demonstrated success in increasing collaboration between clients and practitioners for various health decisions. As the importance of a shared decision making approach becomes increasingly valued in the adult mental health arena, transfer of these ideals to youth and families of youth in the mental health system is a logical next step. A review of the literature and preliminary, formative feedback from families and staff at a Midwestern urban community mental health center guided the development of a framework for youth shared decision making. The framework includes three functional areas (1) setting the stage for youth shared decision making, (2) facilitating youth shared decision making, and (3) supporting youth shared decision making. While still in the formative stages, the value of a specific framework for a youth model in support of moving from a client-practitioner value system to a systematic, intentional process is evident.

Despite the presence of significant psychiatric comorbidity among children with autism spectrum disorders (ASDs), little research exists on those who receive community-based mental health services. This project examined one year (2004) of data from the database maintained by 26 community mental health centers (CMHCs) in the Midwestern US state of Kansas. Children with autism were compared to children with other ASDs - Asperger's disorder, Rett's disorder, and PDD-NOS. Children with autism predictably received more special education services than children with other ASDs, while the latter were more likely to have experienced prior psychiatric hospitalization. Children with ASDs other than autism were also significantly more likely to be diagnosed with attention deficit hyperactivity disorder, oppositional defiant disorder, depressive disorders, and bipolar disorder. In 2004, Kansas CMHCs served less than 15 percent of the children estimated to have an ASD. Implications of these findings are discussed.

the primary aims of this article are to describe the current context for youth shared decision making (sDm) within the U.s. children's mental health system and to identify important considerations for the development of this approach as a research and service domain. the notion is substantiated in the literature that participation in treatment decisions can prepare youth for making their own decisions as adults, can be therapeutic, and can have positive effects on their self-confidence and self-esteem. still, the complex youth-family-provider dynamic raises important issues that need to be addressed before sDm can be successfully implemented.imPliCations FoR PRaCtiCe •Developing a youth sDm model will involve practitioner training, training for youth and parents, defining roles for youth and parents, consent, confidentiality, service delivery factors, and identifying outcomes.

Patient engagement is increasingly recognized as a critical component in improving health care. Yet, there remains a gap in our understanding of the intricacies of rural patient engagement in health-related research. This article describes the process of engaging rural patients, caregivers and broader stakeholders to actively participate in an exploratory effort to understand rural perspectives around the patient-centered medical home model. Highlights of the project's engagement activities demonstrate how giving voice to rural residents can have a significant impact. Lessons learned point to the importance of six factors for successful engagement of rural residents as partners in health care research: building relationships, defining expectations, establishing communication guidelines, developing shared understanding, facilitating dialogue, and valuing contributions.