UW is key contributor to U.S. effort to bolster child welfare

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UW is key contributor to U.S. effort to bolster child welfare

Faculty from the Division of Public Behavioral Health & Justice Policy are involved in three multiyear awards
Brian Donohue

The University of Washington’s Department of Psychiatry and Behavioral Sciences will soon have a greatly increased role in government efforts to improve children’s behavioral health and child welfare.
Faculty members in the department’s Division of Public Behavioral Health & Justice Policy are involved with three multiyear, multimillion-dollar awards announced recently by the U.S. Department of Health and Human Services.

Chart estimating children with mental health disorders

Two grants will establish national centers that guide states and communities to build more effective systems of care for children with behavioral health problems and their families. The centers will counsel an array of state and local agencies so they can collaborate more successfully and base their mental-health and child-welfare services in research-based practices.
A third grant provides five more years of funding for the formal evaluation of the impact of the federal Children’s Mental Health Initiative (CMHI), on which one of the new national centers is focused.
“Funding to these public programs is likely affecting the majority of children who have behavioral health issues or are involved in the welfare system. That federal and state support has been in decline, and the consequences are huge,” said Eric Bruns in explaining the imperative to use these funds efficiently.

ChildMental-computers chart
The chart shows the disparities among states' systems to manage mental health electronic data.
Chart of states' mental health data systems

Bruns, an associate professor, will lead UW’s role in creating a national network of trainers and technical assistants. Trainers will support state and local agencies as they implement systems to address children’s mental-health conditions more effectively. Bruns’ team is one of eight working under the direction of the University of Maryland’s School of Social Work, which received the five-year, $17 million award from the Substance Abuse and Mental Health Services Administration.
“In any community, 5 to 10% of children and adolescents who have the most serious and complex needs wind up consuming 50 or 60% of all behavioral-health resources. A lot of those costs are wasted due to a lack of coordination across the systems that serve these kids,” Bruns said.
A second award will establish the National Center for Evidence Based Practice in Child Welfare. The center’s goal is to improve outcomes for families involved in the child-welfare system – for instance, youth in foster care and parents at risk for having their children removed from their custody.
Research suggests that 70% of child welfare-involved youth have a mental or emotional disorder, so there’s substantial overlap between the populations.

ChildMental-costs graph
Chart detailing U.S. child mental health expenses

“We’ll establish strategies, especially for homes where kids’ behavioral and mental health concerns are factors in their welfare,” said Suzanne Kerns, an assistant professor and UW’s principal investigator in the award. “Local jurisdictions will be the beneficiaries of these best practices.”
Kerns will work with colleagues Lucy Berliner, of Harborview’s Center for Sexual Assault and Traumatic Stress, and Shannon Dorsey in the Department of Psychology. They will establish the center’s curriculum and support its implementation and ongoing self-evaluation.
One best practice they’ll roll out is called “CBT Plus,” an approach to treating anxiety, depression, traumatic stress and behavioral problems. It was formulated by a small UW team that included Berliner and Dorsey.
The evaluation-focused award funds the analysis of outcomes resulting from state and local agencies’ use of grants received from the CHMI.
“Information will be collected from children and families about the child’s functioning – their symptomology, how they’re doing in school – and we’ll also analyze the network to see if organizations are coordinating better with each other over time,” said Michael Pullmann, UW research assistant professor.
Pullmann, with partners at other U.S. universities and organizations, will assist Westat, the firm selected to perform the five-year, $9 million evaluation.
“We’ll look at how agencies are implementing these systems of care, how CHMI funding is shared, what methods work well, best practices for treating children and families – and through this data, enable sites to take corrective actions,” he said.
The awards reflect the many years of nationally prominent research and development work by UW faculty in areas such as child welfare, treatments for child trauma, and integration of behavioral health care. The new awards will allow these faculty and their teams to provide more direct support to the ongoing federal agenda to improve behavioral health and child welfare systems in states and communities.