Abstract
Services to families have traditionally been delivered in a medical model. This presents challenges including workforce shortages, lack of cultural diversity, lack of training in strength-based work, and difficulty in successfully engaging and retaining families in the therapy process. The system of care (SOC) effort has worked to establish formal roles for caregivers in SOC to improve services. This paper provides an example of one community’s efforts to change the SOC by expanding the roles available to caregivers in creating systems change. It describes the model developed by Communities of Care (CoC), a SOC in Central Massachusetts, and its evolution over a 10 year period. First person accounts by system partners, caregivers hired into professional roles as well as a family receiving services, demonstrate how hiring caregivers at all levels can change systems and change lives, not only for those being served but for the caregiver/professionals doing the work. It also demonstrates, however, that change at the system level is incremental, takes time, and can be fleeting unless an ongoing effort is made to support and sustain those changes.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Callejas, L. M., Hernandez, M., Nesman, T., & Mowery, D. (2009). Creating a front porch in systems of care: Improving access to behavioral health services for diverse children and families. Evaluation and Program Planning, 33, 32–35.
Dodge, J. M., & Huang, L. N. (2008). Workforce implications: Issues and strategies for workforce development. In B. A. Stroul & G. M. Blau (Eds.), The system of care handbook: Transforming mental health services for children, youth, and families (pp. 643–662). Baltimore, MD: Paul H Brookes Publishing Co.
DuBrino, T., & Irsfeld, J. A., (2009). Collaborating with families: How to enhance engagement, discover strengths, and talk about problems. University of Massachusetts Medical School: Communities of Care Training and Learning Collaborative.
Huang, L. et al. (2005). Transforming mental health care for children and their families. American Psychologist, 60, 615–627.
Kataoka, S., Zhang, L., & Wells, K. (2002). Unmet need for mental health care among U.S. children: Variation by ethnicity and insurance status. American Journal of Psychiatry, 159(9), 1548–1555.
Mitrani, V. B., Prado, G., Feaster, D. J., Robinson-Batista, C., & Szapocznik, J. (2003). Relational factors and family treatment engagement among low-income, HIV-positive African American mothers. Family Process, 42, 31–45.
National Council of La Raza. (2005). Critical disparities in Latino mental health: Transforming research into action. (p. 6). White Paper. Retrieved June 29, 2011, from http://depressionisreal.org/pdfs/file_WP_Latino_Mental_Health_FNL.pdf.
Osher, T., de Fur, E., Nava, C., Spencer, S., & Toth-Dennis, D. (1998). New roles for families in systems of care. In Systems of care: Promising practices in children’s mental health, 1998 series (Vol. I). Washington, DC: Center for Effective Collaboration and Practice, American Institutes for Research.
Patrick, D., Bigby, J., & Tewksbury, J. E. (2011). Commonwealth of Massachusetts executive office of health and human services, Department of Youth Services 2009 annual report (p. 24). Retrieved June 26, 2011, from http://www.mass.gov/Eeohhs2/docs/dys/annual_report_2009.pdf.
Simpson, J. S., Koroloff, N., Friesen, B. F., & Gac, J. (1998). Promising practices in family-provider collaboration. In Systems of care: Promising practices in children’s mental health, 1998 series (Vol. II). Washington, DC: Center for Effective Collaboration and Practice, American Institutes for Research.
U.S. Census Bureau. (2010). State and county. QuickFacts: Worcester County, MA. Retrieved June 26, 2011, from http://quickfacts.census.gov/qfd/states/25/25027.html.
Walker, J. S., Bruns, E. J., & Penn, M. (2008). Individualized services in systems of care: The wraparound process. In B. A. Stroul & G. M. Blau (Eds.), The system of care handbook: Transforming mental health services for children, youth, and families (pp. 127–153). Baltimore, MD: Paul H. Brookes Publishing Co.
Wenz-Gross, M., DuBrino, T., Irsfeld, J. A., Velez, M., & Perez, A. (2010, March). Implementing a youth and family center model to decrease juvenile justice involvement: Programming, staffing and lessons learned from central Massachusetts communities of care. Symposium conducted at the 23rd annual children’s mental health research and policy conference, Tampa, FL.
Acknowledgments
This work was supported in part by a System of Care cooperative agreement between SAMHSA and the Commonwealth of Massachusetts Department of Mental Health (SM57006).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wenz-Gross, M., Irsfeld, T.D., Twomey, T. et al. Changing the System by Changing the Workforce: Employing Consumers to Increase Access, Cultural Diversity, and Engagement. Am J Community Psychol 49, 546–555 (2012). https://doi.org/10.1007/s10464-011-9473-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10464-011-9473-7