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Program Overview
The Comprehensive Community Mental
Health Services for Children and Their
Families Program (Child Mental Health
Initiative or CMHI) operates under the
auspices of the Child, Adolescent and Family
Branch (CAFB) in the Center for Mental
Health Services (CMHS), Substance Abuse
and Mental Health Services Administration
(SAMHSA) within the Department of Health
and Human Services (HHS). The CMHI is
designed to promote the transformation of the
national mental health care system that serves
children and youth (aged 0 to 21 years)
diagnosed with a serious emotional
disturbance and their families. CMHI funds
the development and implementation of
comprehensive and coordinated ―systems of
care‖ among States, local communities,
United States territories, American Indian
Tribes, and Alaska Native communities.
These systems of care are intended to build
on the individual strengths of the children,
youth, and families being served, and address
their needs. Since CMHI’s inception in 1993,
173 grants and cooperative agreements have
been awarded to communities for this purpose.
To be eligible for CMHI services children and
youth must have, or have had at any time
during the past year, a mental, behavioral, or
emotional disorder of sufficient duration to
meet diagnostic criteria as specified in the
Diagnostic and Statistical Manual for Mental
Disorders, Fourth Edition (DSM–IV;
American Psychiatric Association [APA],
1994) that resulted in functional impairment
that substantially interferes with or limits one
or more major life activities. Beginning with
the 2005 funding announcement, the
Diagnostic Classification of Mental Health
and Developmental Disorders of Infancy and
Early Childhood (DC:0–3; ZERO TO
THREE, 1994) is specified for diagnostic
assessment for children 3 years of age or
younger.
The System of Care Philosophy
and Goals
CMHI was shaped by several Federal and
State initiatives, beginning with the Child and
Adolescent Service System Program (CASSP)
(see Stroul & Friedman, 1986, for a
comprehensive discussion of the program’s
background). CASSP was a national effort
designed to help States and communities build
comprehensive, community-based systems of
care that were youth and family focused.
Since that time, this approach has become the
cornerstone of many mental health service
delivery programs within communities across
the country, and in the territories.
The Federal Action Agenda was the product
of a collaborative effort of the Departments of
Health and Human Services; Education;
Housing and Urban Development; Justice;
Labor; Veteran’s Affairs; and the Social
Security Administration, and was intended to
develop a common national mandate for
mental health services. CMHI was based on
the principles outlined in that document,
which asserted that the mental health service
delivery system must focus its efforts on
helping children with serious emotional
disturbance to ―. . . live, work, learn, and
participate fully in their communities‖
(SAMHSA, 2005, p. 78). SAMHSA’s
utilization of the ―system of care‖ philosophy
as the approach for CMHI funding has made a
substantive contribution to the fulfillment of
this mandate.
System of Care Philosophy
Underlying the system of care approach is the
belief that services should be both
comprehensive and coordinated across public
and private providers, consumers, and other
key stakeholders. When this comprehensive
and coordinated system is in place, it is
The Comprehensive Community Mental Health Services for Children and Their Families Program Evaluation Findings
2006–2008 Annual Report to Congress ● Page 1