Health System: Mental Health Youth Services (6130P)


Program Outcome Statement

Improve mental health for children, youth, and their families

Program Services

  • Outreach
  • Assessment
  • Counseling
  • Treatment
  • Case Management
  • Medication
  • Assistance Managing Care

Overview

Behavioral Health & Recovery Services (BHRS) for Children/Youth/Families provides outreach, assessment, counseling, treatment, case management, medication, and assistance with managing care to seriously emotionally disturbed children, youth, and their families. BHRS provides services to 4,500 youth. Many children come to BHRS through the child welfare system due to abuse or neglect. Others come to BHRS through Juvenile Probation, as their mental illness or substance abuse has contributed to their involvement with the criminal justice system. BHRS also provides emergency and inpatient care for approximately 300 children and youth in crisis and operates the Canyon Oaks Youth Center, a 12-bed residential treatment facility.
In partnership with schools, Child Welfare, and Probation, services are provided to maintain severely emotionally disturbed youth in their homes and schools and promote their safety and well-being. BHRS, Child Welfare, and Probation have substantially reduced the out-of-home placement rate over the last five years and successfully maintained high-risk youth in community settings, a less disruptive, more cost-effective solution than placement. BHRS implemented Full Service Partnerships in 2005 to serve high-risk youth with a broad array of services in their homes and community settings. These services have helped prevent youth from being placed out-of-home, and when out-of home placements have been necessary, these services have made it possible to return youth home sooner.
A change in state law in 2010 provided local school districts the option to significantly change the provision of mental health services for students in Special Education by selecting new providers. BHRS continues to provide mental health services for most of the districts’ children in Special Education. Additional collaborative efforts planned by the countywide Children and Youth System of Care (CYSOC) Committee and the School Safety Summit Task Force are focused on removing barriers to mental health services so that schools are safe and all emotionally disturbed children and youth receive access to the treatment they need to thrive.

Average Monthly Census of Youth in Out-of-County Group Home Placement Exceeding Target

Percent of Youth Who Attend a Follow-Up Visit with a Clinical Provider within 7 Days of Being Discharged from a Psychiatric Hospital Approaching Target

Percent of Emotionally Disturbed Young Adults Receiving Full Service Partnership Services who Experience a Reduction in Days Hospitalized Below Target

FY 2017-18 Year-End Story Behind Performance

Average Monthly Census of Youth in Out-of-County Group Home Placement

Out of County placements continue to decline as service populations for Probation, Child and Family Services, and BHRS Youth & Family System of Care are declining in concert with shifting demographics in the County. Further, out of county placements are typically more complex and BHRS youth services has become more specialized, focusing on complex interventions and therapies needed to address the these issues by expanding the role of BHRS in youth development to assist youth to be free of barriers to education and learning and monitoring population health with a focus on prevention and early intervention.

Percent of Youth Who Attend a Follow-Up Visit With a Clinical Provider Within 7 days

It is important to recognize that nearly every youth is engaged while hospitalized. This measure addresses follow-up post-hospitalization, which is often not necessary because plans are developed and agreed to prior to discharge.  These cases are not measured by this instrument. This practice is reflected in prior year results. However, there is an increase in fiscal year 2017-18 results, partially due to corrected measurement logic, which now reflects hospital-based clinician charges after discharge that were incorrectly excluded because it was presumed to be a cost while the youth was hospitalized. The measure now reflects the very good work being done to support youth that become hospitalized.


Percent of Emotionally Disturbed Young Adults Receiving Full Service Partnership Services who Experience a Reduction in Days Hospitalized

Full Service Partnerships have had significant impacts on clients and have resulted in major reductions in homelessness, incarceration, and hospitalizations. As the program matures, a number of the more than 300 slots are occupied by the same individuals. Therefore, as the universe of clients that can continue to improve for this measure shrinks, the total percentage that experience a reduction is less because most have already achieved few to no hospitalizations. This measure would be effective if all Full Service Partnership slots completely turned over from year to year, but this not the case.  Only 20 percent of the slots change annually. After a couple of years in the program, participants experience little to no hospitalizations as is the case for nearly 80 percent program participants, many of whom have been in the program for five or more years.  To address these issues, the measure will be limited to clients in the program one year or less in fiscal year 2018-19.



Future Priorities

  • Successfully transition Canyon Oaks Youth Center through Continuum of Care Reform by achieving Short-Term Residential Treatment Program status and Commission of Accreditation of Rehabilitation Facilities accreditation.
  • Strengthen the continuum of services to prevent admissions and support clients after discharge from an acute inpatient placement.
  • Continue to build positive relationships with school districts and campuses that result in space for field-based BHRS staff and strong partnerships that support students at school.
  • Develop strategies and provide training that equips staff to effectively address recently recognized conditions such as eating disorders.


Author: Gina Wilson; CFO, Health System      Contact Email: gwilson@smcgov.org      Last Updated: 08-30-2018