The Promise of Family Engagement: An Action Plan for System-Level Policy and Advocacy
In its blueprint for mental healthcare reform, the President’s New Freedom Commission outlined a plan for system transformation that prioritized consumer and family-driven care (2003). This federal policy position came on the heels of the Surgeon General’s Report on Children’s Mental Health (1999), advocating an integrated service system model that is inclusive of family engagement. Children’s mental health policy affects children, youth, and families at both the individual treatment level and the system level. The individual level refers to the ways in which direct care staff members interact with individual youth, families, and their support systems in the planning and delivery of services and supports (Rosenblatt, 1998). In contrast, the system level refers to the structural, administrative, and fiscal organization of a continuum of services and supports including linkages between child-serving agencies such as mental health, child welfare, juvenile justice, and education in a community-based setting (Rosenblatt, 1998). Although the past 20 years have marked significant expansion in the role of families in individual treatment-level decision making (Hoagwood, 2005), consistent and meaningful engagement of families in system-level policy action has been much more difficult to accomplish. Knitzer and Cooper (2006) note considerable variation across states related to family advocacy as well as value-driven conflict around family empowerment in system-level decision making.
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