system of care for rhode island's children, youth and families

CHAPTER 2: COMMUNITY-STATE PREVENTION
PARTNERSHIPS/ROLE OF THE CHILDREN’S CABINET
Community and State Leaders clearly recognize the important role prevention services play
in the system of care and in supporting children, youth, and families for success. The
promotion of emotional and physical health is a key responsibility of the Children’s Cabinet
in partnership with local communities. The system’s foundation is the commitment of local
communities and the State to ensuring that all neighborhoods have strong prevention and
educational services to support the complex needs of their children and families. The
Children’s Cabinet provides leadership in regard to the development of a structure by which
collaboration among state agencies is explicitly described and implemented, including
dedicating personnel and other resources.
The principles of family-centered (see Appendix B) and culturally competent (see
Appendix C) practice are embedded values in the Ideal System of Care’s community-based
prevention services. The system ensures that families and the multiple cultural, linguistic
and religious groups that make up the community are viewed as valuable and equal partners
at all levels of development, implementation and service delivery. Built upon CASSP
principles (see Appendix D), this system ensures that decisions regarding treatment and care
are made on an individual basis according to the strengths, risks, and needs of families and
the best interest of the child with a recognition of available fiscal resources.
Rhode Island’s Ideal System understands the role it plays in promoting the mental health of
children as defined by the US Surgeon General 8 . It is a system geared at all levels to the
earliest possible intervention, prevention, crisis intervention, and family stabilization in order
to provide children with the greatest opportunities to achieve and maintain good mental
health. It has the capacity to provide services to all children and families at the level 9 , 10
of
8 “Spanning roughly 20 years, childhood and adolescence are marked by dramatic changes in physical,
cognitive, and social-emotional skills and capacities. Mental health in childhood and adolescence is defined by
the achievement of expected developmental cognitive, social and emotional milestones and by secure
attachments, satisfying social relationships, and effective coping skills (Surgeon General’s Report, 2000,
p.123)”.
9 The MECA study (Methodology for Epidemiology of Mental Disorders in Children and Adolescents)
estimated that [nationwide] almost 21 percent of US children ages 9 to 17 had a diagnosable mental or addictive
disorder associated with at least minimum impairment (Surgeon General’s Report, 2000, p.123)”. Eleven
percent of youth have significant functional impairment. This estimate translates into a total of 4 million youth
who suffer from a major mental illness that results in significant impairments at home, at school and with peers
and five percent are classified with extreme functional impairment (Surgeon General’s Report, 2000, p.124).
10 The foremost finding in the Surgeon General’s report is that [nationwide] most children in need of mental
health services do not get them (p. 180). The conclusion that a high proportion of young people with a
diagnosable mental disorder do not receive any mental health service at all (Burns, et al., 1995; Leaf et al.,
1996) reinforces an earlier report by the US Office of Technology Assessment (1986) which indicated that
approximately 70 percent of children and adolescents in need of treatment do not receive mental health
services. Only one in five children with a serious emotional disturbance used mental health specialty services
although twice as many such children received some form of mental health intervention (Burns et al, 1995).
Thus, about 75 to 80 percent fail to receive specialty services, and the majority of these fail to receive any
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