Children's mental health: The gap between what we know and what we do.

Abstract

There is widespread agreement that over 11% of our nation’s children need mental health treatment, but the majority of these children receive inadequate or inappropriate treatment. This gap between what we know should be provided and what is provided is the result of a poorly structured health care financing system and a poorly coordinated treatment system. The treatment system fails to recognize that children’s mental health problems are interactions between intraindividual difficulties and environmental conditions. A wealth of models of prevention and treatment have been developed, and a substantial scientific basis for children’s mental health interventions now exists, but there is a shortage of community-based services and a lack of coordination across services. Public policy toward children with mental health problems must encourage application of knowledge about effective treatment systems and encourage care in the least restrictive and most cost-effective settings.

Consultant and client outcomes of competency-based behavioral consultation training.

“…There are growing numbers of students requiring alternative assistance (Saxe, Cross, & Silverman, 1988), however current models of service delivery appear to be ineffective in meeting the needs of these children and adolescents (Christenson, Ysseldyke, & Algozzine, 1982;Knitzer, 1982;Ysseldyke, Algozzine, Richey, & Graden, 1982). Individuals across disciplines have advocated for alternative methods of addressing the needs of all students (AASA, 1988;Lloyd, Singh, & Repp, 1991;NASP/NCAS, 1985;Phillips & McCullough, 1990;Stainback & Stainback, 1991;Zins, Curtis, Graden, & Ponti, 1988) and consultation has been offered as the foundation for a range of alter-native services designed to enhance general educational experiences (Curtis & Meyers, 1988;.…”

Wrapping community-based mental health services around children with a severe behavioral disorder: An evaluation of project wraparound

“…health services has been the increasing recognition that many of the children and youth who could benefit from mental health services have not been receiving them (Burns, 1991;Knitzer, 1982;Tuma, 1989). Recent epidemiological studies estimate that 8-12% of all children and adolescents have sufficient emotional difficulties to warrant intervention (Brandenberg, 1988;Costello, 1989;Saxe, Cross, & Silverman, 1988;Institute of Medicine, 1989). Yet, in an extensive review of children's mental health service provision, the United States office of Technology Assessment (OTA, 1986) estimated that 70-80% of these children may not be getting appropriate services.…”

Consultation and Teaming: Problem Solving among Educators, Parents, and Support Personnel

“…It is currently recognized across disciplines that there are growing numbers of students requiring alternative assistance (American Association of School Administrators, 1988;Saxe, Cross, & Silverman, 1988) and that current models of service delivery are ineffectively meeting the needs of these children and adolescents (Knitzer, 1982). Consultation and other forms of collaborative problem solving across disciplines have been espoused by many as the foundations for a range of alternative services designed to enhance general educational experiences (Cole & Siegel, 1990;Curtis & Meyers, 1988;Idol et al, 1986;Phillips & McCullough, 1990).…”