Post on 10-Mar-2020
Wisconsin Family Ties, Inc.
16 N. Carroll Street, Suite 230, Madison, WI 53703
608.267.6800 | 800.422.7145 | wifamilyties.org
Barriers to Accessing Mental Health Services
Provider Competence / Fit
System
Diagnosis, eligibility & rules
• Skill / approach
• Philosophy
• Over-reliance on medication
• Family-driven perspective
• Understands idiosyncratic communication patterns
• Directive vs. collaborative
Provider Competence / Fit
Diagnosis, eligibility & rules
Comprehensive Community Services (CCS)
• Eligibility Must have “diagnosis of mental disorder” DHS 36.14(1) Cannot be denied because of “disability” DHS 36.13(4)
• Service transition • Do not have to give up ABA service, but do have to use a
psychotherapist in the CCS provider network (ForwardHealth Update 2014-42)
• Informed consent • Consumer-driven DHS 36.03(7)
• Choice • In selection of team members, services, and providers
DHS 36.19(1)(a)
System
system noun sys·tem | \ ˈsi-stəm \
1: set of things working together
as parts of a mechanism or an
interconnecting network to form
a unified whole.
2: harmonious arrangement or
pattern
Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential
Services
Hospitalization (Voluntary)
Child Welfare System
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
Juvenile Justice System
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
Best for kids
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
Best for kids
adadfasdfadsfadf
Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
Best for providers
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
Best for providers
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
Most efficient
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
Most efficient
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
Cost-effective
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
Cost-effective
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Intensity of mental health need
Pare
nta
l Co
ntr
ol
Outpatient & Medication
Services Community-based
Support Programs
Detention / Corrections
Hospitalization (Involuntary)
Out-of-Home Residential Services
Hospitalization (Voluntary)
These are the structures we have
Child Welfare System
Juvenile Justice System
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Children 0-12 Receiving Public Mental Health Services (Per 1,000 children with SED)
Wisconsin
National average
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Wisconsin
National average
Children 13-17 Receiving Public Mental Health Services (Per 1,000 children with SED)
0.0
5.0
10.0
15.0
20.0
25.0
2012 2013 2014 2015 2016 2017
Children 0-17 Served in Community MH Programs (Per 1,000 children with SED)
Wisconsin
National average
0.0
0.1
0.2
0.3
0.4
0.5
0.6
2012 2013 2014 2015 2016 2017
Children 0-17 Served in State Psychiatric Hospitals (Per 1,000 children with SED)
Wisconsin
National average
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Parental Satisfaction with Outcome from Services
Wisconsin
National average
Social Supports Clinical
Care
Relative Effect on Health Outcomes
Importance of Peer Support
Peer Support & Parent Peer Support: Impact and Relative Importance as Reported by Service Recipients (Ruffalo, Davis, et al., Medical College of Wisconsin, 2016)
0
5
10
15
20
25
30
35
40
45
Special education Case management Psychiatric services Psychotherapy Peer support
Pe
rce
nta
ge
of
Re
spo
nd
en
ts
Categories of Service
Service Respondents Ranked Most Important
REIMAGINE Human Services
REIMAGINE Human Services
Create a separate children’s mental health code in state statute that ensures:
• a comprehensive service array
• voluntary access to mental health services without having to file a CHIPS petition and enter the child-welfare system
• an expanded network of in-home and community-based services and supports
• residential treatment, when needed, specifically designed to address mental health issues
• eligibility screening for Medicaid-related services based on state-of-the-art assessment practices
REIMAGINE Human Services
Joanne Juhnke Wisconsin Family Ties’ Policy Director
joanne@wifamilyties.org
(608) 261-0532