The rate of youth with mental health needs is disproportionately high in juvenile justice. Wraparound planning involves families and providers in coordinating juvenile justice, mental health, and other services and supports. This study compares data from two groups of juvenile offenders with mental health problems: 106 youth in a juvenile justice wraparound program called Connections and a historical comparison group of 98 youth in traditional mental health services. Cox regression survival analyses revealed that youth in Connections were significantly less likely to recidivate at all, less likely to recidivate with a felony offense, and served less detention time.

Efforts to move the system of care for children with serious emotional disorders toward community-based alternatives has prompted a growing recognition of the need for supportive services for families. This article examines the shifts in policy and administrative practice that are needed in order to move toward a family-centered system of care. Proactive administrative support is particularly important in this system shift. Four important barriers to a family-centered system of care are examined: (1) efforts have tended to focus on the child as the unit of services, rather than on the family; (2) efforts have tended to focus primarily on mental health services, rather than considering the full range of services needed by the child and family; (3) efforts have tended to emphasize formal services, often ignoring the support provided by informal networks; and (4) the resources and expertise of parents and other family members have not been used. New roles for parents--which involve working with administrators and researchers are discussed.

An intervention designed to address barriers that interfere with access to children's mental health services for low-income families was implemented in three Oregon counties; four other counties were included as a comparison condition. The intervention involved the use of paraprofessionals called Family Associates who provided families with information, emotional support, and tangible assistance to reduce barriers to services. Families in the intervention group ( n = 96) were significantly more likely to initiate children's mental health services than were those in the comparison group ( n = 143); however, the groups did not differ in their rates of appointment attendance or discontinuing services prematurely. A modest but significant difference between the groups was found for family and service system empowerment, with the intervention families reporting higher levels of empowerment at post-test. The barriers to children's mental health services experienced by the intervention families and the barriers for which Family Associate services were provided are described.

The family associate is a parent without professional mental health training who acts as a system guide to low-income families whose children have been referred to mental health services through the Early and Periodic Screening, Diagnosis and Treatment program. The family associate provides emotional support, information about mental health services and community resources, and directs assistance, such as help with transportation and child care. Based on the belief that parent-to-parent support can be a powerful tool in overcoming the barriers to accessing services, the family associate role has been successfully implemented in three counties in Oregon. The family associate role and its implementation, characteristics of the families who participated, and the implications for introducing this role into traditional mental health service systems are described.

Within children's mental health, there is an increasing demand for wider implementation of wraparound and other interventions that can provide comprehensive, individualized, family-driven care. Unfortunately, implementation has proven difficult because these approaches do not necessarily flourish within traditionally organized agencies and systems. This has highlighted the need for information about how mental health agencies and systems must evolve if they are to provide a hospitable implementation environment for these interventions. A first step in developing this information is through research that advances conceptual and theoretical understanding of the impact of contextual factors on implementation. At the same time, there is an immediate need for practical information to guide decision making and policy development in settings where implementation is being undertaken. This article describes a study of wraparound implementation that used a combination of qualitative strategies to meet both of these needs simultaneously. It is argued that these strategies are particularly well suited to the study of emerging practices that reflect-and help drive-transformation in mental health systems.