Systems of Caregiving: The Promotion of Positive Mental Health Outcomes in Children and Adolescents

  • Patricia Stone Motes
  • Chaundrissa Oyeshiku Smith
Part of the Caregiving: Research • Practice • Policy book series (CARE)


Promoting mental health and preventing mental disorders in children and adolescents is critical to the overall health of our country. National estimates indicate that about six to nine million children in the USA suffer from a major mental illness. Successful efforts in promoting mental health for children and adolescents require attention from a range of caregiving systems, including mental health, education, juvenile justice, child welfare, developmental disabilities, substance abuse, and the primary care sector. This chapter addresses research, practice, and policy implications as multiple caregiving systems work to promote positive mental health outcomes for children and adolescents.


Mental Health Mental Health Service Family Caregiver Mental Health Outcome Emotional Disturbance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Adelman, H. S., Barker, L. A., & Nelson, P. (1993). A study of a school-based clinic: Who uses it and who doesn’t? Journal of Clinical Child Psychology, 22, 52–59.CrossRefGoogle Scholar
  2. American Academy of Pediatrics. (1996). The classification of child and adolescent mental diagnoses in primary care: Diagnostic and statistical manual for primary care, child and adolescent version. Elk Grove Village, IL: American Academy of Pediatrics.Google Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington: American Psychiatric Association.Google Scholar
  4. Bickman, L. (1996). Implications of a children’s mental health managed care demonstration evaluation. Journal of Mental Health Administration, 23, 107–117.PubMedCrossRefGoogle Scholar
  5. Bickman, L., Lambert, W.E., Angrade, A.R., Penaloza, R.V. (2000). The Fort Bragg continuum of care for children and adolescents: Mental health outcomes over 5 years. Journal of Consultation and Clinical Psychology, 68, 710–716.Google Scholar
  6. Bronfenbrenner, U. (1979). The ecology of human development: Experiements by nature and design. Cambridge: Harvard University Press.Google Scholar
  7. Burns, B., & Friedman, R. (1990). Examining the research base for child mental health services and policy. Journal of Mental Health Administration, 17, 87–98.PubMedCrossRefGoogle Scholar
  8. Burns, B., Costello, E.J., Angold, A., Tweed, D., Stangl, D., Farmer, E.M., Erkanli, A. (1995). Children’s mental health service use across service sectors. Health Affairs, 14, 147–159.Google Scholar
  9. Center for Mental Health Services. (1997). Annual report to Congress on the evaluation of the comprehensive community mental health services for children and their families program, 1997. Atlanta: Macro International Inc.Google Scholar
  10. Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care: A monograph on effective services for minority children who are severely emotionally disturbed. Washington: CASSP Technical Assistance Center, Georgetown University Child Development Center.Google Scholar
  11. Crowley, M. J., & Kazdin, A. E. (1998). Child psychosocial functioning and parent quality of life among clinically referred children. Journal of Child and Family Studies, 7, 233–251.CrossRefGoogle Scholar
  12. Curtis, W. J., & Singh, J. J. (1996). Family involvement and empowerment in mental health service provision for children with emotional and behavioral disorders. Journal of Child and Family Studies, 5, 503–517.CrossRefGoogle Scholar
  13. DeChillo, N., Koren, P. E., & Schultze, K. H. (1994). From paternalism to partnership: Family and professional collaboration in children’s mental health. American Journal of Orthopsychiatry, 64, 564–576.PubMedCrossRefGoogle Scholar
  14. Dishion, T. J., & McMahon, R. J. (1998). Parental monitoring and the prevention of child and adolescent problem behavior: A conceptual and empirical formulation. Clinical Child and Family Psychology Review, 1, 61–75.PubMedCrossRefGoogle Scholar
  15. Downey, G., & Coyne, J. C. (1990). Children of depressed parents: An integrative review. Psychological Bulletin, 108, 50–76.PubMedCrossRefGoogle Scholar
  16. Dryfoos, J. G. (1990). Adolescents at risk: Prevalence and prevention. New York: Oxford University Press.Google Scholar
  17. Duchnowski, A. J., & Friedman, R. M. (1990). Children’s mental health: Challenges for the nineties. Journal of Mental Health Administration, 17, 3–12.PubMedCrossRefGoogle Scholar
  18. Duchnowski, A. J., Kutash, K., & Friedman, R. M. (2002). Community-based interventions in a system of care and outcomes framework. In B. J. Burns & K. Hoagwood (Eds.), Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders (pp. 16–37). New York: Oxford University Press.Google Scholar
  19. Dunst, C. J., Trivette, C., & Paget, A. (1994). Supporting and strengthening families. Cambridge: Brookline Books.Google Scholar
  20. Dunst, C. J., Trivette, C. M., & Deal, A. G. (1988). Enabling and empowering families: Principles and guidelines for practice. Cambridge: Brookline Books.Google Scholar
  21. Early, T. J., Gregorie, T. K., & McDonald, T. P. (2002). Child functioning and caregiver well-being in families of children with emotional disorders: A longitudinal analysis. Journal of Family Issues, 22, 374–391.CrossRefGoogle Scholar
  22. Eber, L., & Nelson, C. M. (1997). Integrating services for students with emotional and behavioral needs through school-based wraparound planning. American Journal of Orthopsychiatry, 67, 385–395.PubMedCrossRefGoogle Scholar
  23. Eber, L., Osuch, R., & Redditt, C. A. (1996). School-based applications of the wraparound process: Early results on service provision and student outcomes. Journal of Child and Family Studies, 5, 83–99.CrossRefGoogle Scholar
  24. Epstein, M. H., Kutash, K., & Duchnowski, A. (1998). Outcomes for children and youth with emotional and behavioral disorders and their families: Programs and evaluation best practices. Austin: Pro-Ed Inc.Google Scholar
  25. Farmer, E. M. Z., Burns, B. J., Angold, A., & Costello, E. J. (1997). Impact of children’s mental health problems on families: Relationships with service use. Journal of Emotional and Behavioral Disorders, 5, 230–238.CrossRefGoogle Scholar
  26. Floyd, A. (2007). Collaboratives: Avenues to build community capacity. In P.S Motes & P. Hess (Eds.) Collaborating with community-based organizations through consultation and technical assistance. New York: Columbia UUniversity Press.Google Scholar
  27. Fox, N., Leone, P., Rubin, K., Oppenheim, J., Miller, M., & Friedman, K. (1999). Final report on the linkages to learning program and evaluation at Broad Acres Elementary School. Washington: U.S. Department of Education.Google Scholar
  28. Friesen, B. J., & Stephens, B. (1998). Expanding family roles in the system of care: Research and practice. In M. R. Epstein, K. Kutask, & A. J. Duchnowski (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families: Programs and evaluation, best practices (pp. 231–259). Austin: Pro-Ed Inc.Google Scholar
  29. Greenbaum, S. D. (1998). The role of ethnography in creating linkages with communities: Identifying and assessing neighborhoods’ needs and strengths. In M. Hernandez & M. R. Isaacs (Eds.), Promoting cultural competence in children’s mental health services (pp. 119–132). Baltimore: Paul H. Brookes.Google Scholar
  30. Greenberg, M. T., Kusche, C., & Mihalic, S. F. (1998). Blueprints for violence prevention: Promoting alternative thinking strategies. Boulder: University of Colorado, Institute of Behavioral Science, Center for the Study and Prevention of Violence.Google Scholar
  31. Hammer, K. M., Lambert, E. W., & Bickman, L. (1997). Children’s mental health in a continuum of care: Clinical outcomes at 18 months for the Fort Bragg Demonstration. Journal of Mental Health Administration, 24, 465–471.Google Scholar
  32. Hanley, J. H., & Wright, H. (1995). Child mental health professionals: The missing link in child mental health reform. Journal of Child and Family Studies, 4(4), 383–388.CrossRefGoogle Scholar
  33. Hawkins, J. D., & Catalano, R. F. (1992). Communities that care: Action for drug abuse prevention (1st ed.). San Francisco: Jossey-Bass.Google Scholar
  34. Hawkins, J., Catalano, R., & Miller, J. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, 64–105PubMedCrossRefGoogle Scholar
  35. Henggeler, S. W., & Borduin, C. M. (1990). Family therapy and beyond: A multisystemic approach to treating the behavior problems of children and adolescents. Pacific Grove: Brooks/Cole.Google Scholar
  36. Henggeler, S. W., Mihalic, S. F., Rone, L., Thomas, C., & Timmons-Mitchell, J. (1998). Blueprints for violence prevention, book six: Multisystemic therapy. Boulder: Center for the Study and Prevention of Violence.Google Scholar
  37. Henggeler, S. W., Schoenwald, S. K., Pickrel, S. G., Rowland, M. D., & Santos, A. B. (1994). The contribution of treatment outcome research to the reform of children’s mental health services: Multisytemic family therapy as an example. Journal of Mental Health Administration, 21, 229–239.PubMedCrossRefGoogle Scholar
  38. Hoagwood, K., Burns, B. J., Kiser, L., Ringeisen, H., & Schoenwald, S. K. (2001). Evidence-based practice in child and adolescent mental health services. Psychiatric Services, 52(9), 1179–1189.PubMedCrossRefGoogle Scholar
  39. Hochberg, M. R. (1993). Building villages to raise our children: Staffing. Cambridge: Harvard Family Research Project.Google Scholar
  40. Holtzman, H. (1992). School of the future. Austin: American Psychological Association and Hogg Foundation for Mental Health.CrossRefGoogle Scholar
  41. Jivanjee, P. R., & Friesen, B.J. (1997). Shared expertise: Family participation in interprofessional training. Journal of Emotional and Behavioral Disorders, 5, 205–211.CrossRefGoogle Scholar
  42. Knitzer, J. (1982). Unclaimed children: The failure of public responsibility to children and adolescents in need of mental health services. Washington: Children’s Defense Fund.Google Scholar
  43. Knitzer, J., Steinberg, Z., & Fleisch, B. (1993). At the schoolhouse door: An examination of programs and policies for children with behavioral and emotional problems. New York: Bank Street College of Education.Google Scholar
  44. Koren, P., Paulson, R. W., Kinney, R. F., Yatchmenoff, D. K., Gordon, L. J., & DeChillo, N. (1997). Service coordination in children’s mental health: An empirical study from the caregiver’s perspective. Journal of Emotional and Behavioral Disorders, 5(3), 162–172.CrossRefGoogle Scholar
  45. Kretzman, J. P., & McKnight, J. L. (1993). Building communities from the inside out: A path toward finding and mobilizing a community’s assets. Evanston: Northwestern University, Center for Urban Affairs and Policy Research, Neighborhood Innovations Network.Google Scholar
  46. Kutash, K., & Duchnowski, A. J. (1997). Create comprehensive and collaborative systems. Journal of Emotional and Behavioral Disorders, 11, 66–75.CrossRefGoogle Scholar
  47. Kutash, K., Duchnowski, A. J., Sumi, W. C., Rudo, Z., & Harris, K. M. (2002). A school, family, and community collaborative program for children who have emotional disturbances. Journal of Emotional and Behavioral Disorders, 11, 66–75.Google Scholar
  48. LaGreca, A. M., & Hughes, J. N. (1999). United we stand, divided we fall: The education and training needs of clinical child psychologists. Journal of Clinical Child Psychology, 28, 435–447.CrossRefGoogle Scholar
  49. Leone, P. E., Evert, R.J., & Friedman, K. (2002). Building linkages to learning through community partnerships. In B. Algozzine & P. Kay (Eds.), Preventing problem behaviors (pp. 126–141). Thousand Oaks: Corwin.Google Scholar
  50. Leone, P., Lane, S., & Arllen, N., & Peter, H. (1996). School-linked services in context: A formative evaluation of Linkages to Learning. Special Services to the Schools, 11, 119–133.CrossRefGoogle Scholar
  51. Lewinsohn, P. M., Roberts, R. E., Seeley, J. R., Rohde, P., Gotlib, I. H., & Hops, H. (1994). Adolescent psychopathology: II. Psychosocial risk factors for depression. Journal of Abnormal Psychology, 103, 302–315.PubMedCrossRefGoogle Scholar
  52. Lindahl, K. M., & Malik, N. M. (1999). Linking marital conflict and children’s adjustment: The role of triadic family processes in Anglo and Hispanic families. Journal of Clinical Child Psychology, 28, 12–24.PubMedCrossRefGoogle Scholar
  53. Mayes, L. C. (1999). Addressing mental health needs of infants and young children. Child and Adolescent Psychiatric Clinics of North America, 8, 209–224.PubMedGoogle Scholar
  54. McCabe, K. M., Clark, R., & Barnett, D. (1999). Family protective factors among urban African American youth. Journal of Clinical Child Psychology, 28(2), 137–150.PubMedCrossRefGoogle Scholar
  55. McGinty, K., McCammon, S. L., & Koeppen, V. P. (2001). The complexities of implementing a wraparound approach to service provision: A view from the field. Journal of Family Social Work, 5, 95–110.CrossRefGoogle Scholar
  56. McLaughlin, M. J., Leone, P. E., Meisel, S., & Henderson, K. (1997). Strengthen school and community spirit. Journal of Emotional and Behavioral Disorders, 5, 15–23.CrossRefGoogle Scholar
  57. Miller, D. N., DuPaul, G. J., & Lutz, J. G. (2002). School-based psychosocial interventions for childhood depression: Acceptability of treatments among school psychologists. School Psychology Quarterly, 17, 78–99.CrossRefGoogle Scholar
  58. Modrcin, M. J., & Robison, J. (1991). Parents of children with emotional disorders: Issues for consideration and practice. Community Mental Health Journal, 27, 281–293.PubMedCrossRefGoogle Scholar
  59. Motes, P. S., Melton, G., Pumariega, A., & Simmons, W. W. (1999). Ecologically-oriented school-based mental health services: Implications for service system reform. Psychology in the Schools, 36, 391–401.CrossRefGoogle Scholar
  60. Olson, A. L., Kelleher, K. J., Kemper, K. J., Zuckerman, B. S., Hammond, C. S., & Dietrich, A. J. (2001). Primary care pediatricians’ roles and perceived responsibilities in the identification and management of depression in children and adolescents. Ambulatory Pediatrics, 1, 91–98.PubMedCrossRefGoogle Scholar
  61. Petersen, A. C., Compas, B. E., Brooks-Gunn, J., Stemmler, M., Ey, S., & Grant, K E. (1993). Depression in adolescence. American Psychologist, 48, 155–168.PubMedCrossRefGoogle Scholar
  62. Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. M., Jones, J., et al. (1997). Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association, 278(10/September 10), 823–832.PubMedCrossRefGoogle Scholar
  63. Roeser, R., & Midgley, C. (1997). Teachers’ views of issues involving students’ mental health. Elementary School Journal, 98, 115–133.CrossRefGoogle Scholar
  64. Sanders, M. R. (1999). Triple P-Positive Parenting Program: Towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clinical Child and Family Psychology Review, 2, 71–90.PubMedCrossRefGoogle Scholar
  65. Skiba, R. J., & Nichols, S. (2000). What works in wraparound programming. In M. P. Kluger, G. Alexander, & P. A. Curtis (Eds.), What works in child welfare (pp. 23–32). Washington: CWLA.Google Scholar
  66. Stroul, B. A. (1988). Series on community-based services for children and adolescents who are severely emotionally disturbed, Vol. I: Home-based services. Washington: CASSP Technical Assistance Center, Georgetown University Child Development Center.Google Scholar
  67. Stroul, B., & Freidman, R. (1986). A system of care: Children and youth with severe emotional disturbance. Washington: Georgetown University Child Development Center, National Technical Assistance Center for Children’s Mental Health.Google Scholar
  68. Suarez, L. M., & Baker, B. L. (1997) Child externalizing behavior and parents’ stress: The role of social support. Family Relations, 46, 373–381.CrossRefGoogle Scholar
  69. Thompson, R. W., Ruma, P. R., Brewster, A. L., Besetsney, L. K., & Burke, R. V. (1997). Evaluation of an Air Force child physical abuse prevention project using the reliable change index. Journal of Child and Family Studies, 6, 421–434.CrossRefGoogle Scholar
  70. U.S. Department of Education. (1994). National agenda for achieving better results for children and youth with serious emotional disturbance. Washington: Office of Special Education Programs.Google Scholar
  71. U.S. Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General, executive summary. Rockville: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.Google Scholar
  72. U.S. Public Health Service. (2000). Report of the Surgeon General’s conference on children’s mental health: A national action agenda. Washington: Department of Health and Human Services, 2000.Google Scholar
  73. Wagner, M. M. (1995). Outcomes for youths with serious emotional disturbance in secondary school and early adulthood. Critical Issues for Children and Youth, 5, 90–112Google Scholar
  74. Waxman, R. P., Weist, M. D., & Benson, D. M. (1999). Toward collaboration in the growing education-mental health interface. Clinical Psychology Review, 19(2), 239–253.PubMedCrossRefGoogle Scholar
  75. Wills, T. A., Vaccaro, D., & McNamara, G. (1992). The role of life events, family support, and competence in adolescent substance abuse: A test of vulnerability and protective factors. American Journal of Community Psychology, 20(3), 349–374.PubMedCrossRefGoogle Scholar
  76. Winters, N. C., & Pumarieaga, A. J. (2001). Systems of care for children and adolescents with serious emotional difficulties. In V. H. Booney & A. J. Pumariega (Eds.), Clinical assessment of child and adolescent behavior (pp. 513–532). New York: Wiley.Google Scholar
  77. Yoe, J., Santarcangelo, S., Atkins, M., & Burchard, J. (1996). Wraparound care in Vermont: Program development, implementation, and evaluation of a statewide system of individualized services. Journal of Child and Family Studies, 5, 22–39.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Patricia Stone Motes
    • 1
  • Chaundrissa Oyeshiku Smith
    • 2
  1. 1.Division of Policy and Research on Medicaid and MedicareInstitute for Families in Society, University of South CarolinaColumbiaUSA
  2. 2.Department of Psychiatry and Behavioral SciencesEmory University School of MedicineAtlantaUSA

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