Missouri Comprehensive Children’sMissouri Comprehensive Children’sMissouri Comprehensive Children’sMissouri Comprehensive Children’sMissouri Comprehensive Children’sMental Health ServicesMental Health ServicesMental Health ServicesMental Health ServicesMental Health Services

PUTTING ALL THEPUTTING ALL THEPUTTING ALL THEPUTTING ALL THEPUTTING ALL THEPIECES TOGETHERPIECES TOGETHERPIECES TOGETHERPIECES TOGETHERPIECES TOGETHER

It is our goal to partner with families and youthliving with serious emotional disorders to helpyouth improve themselves, succeed in school, andbecome productive members of the community...

...through interagency collaboration in a system of care that allows families tobe responsible for leading the treatment team and wraps individualized servicesaround the entire family. The following information demonstrates that serving achild through a system of care model is successful and cost effective.

The Missouri Comprehensive Children’sMental Health Services uses a Wrap Aroundphilosophy within a System of Care model.

System of CareApproach

Any agency or organization that is currentlyworking with the family becomes part of theSystem of Care team. The family leads this teamto work together to meet the goals of the familyby providing individualized, strength-basedservices in a coordinated effort.

The Wrap AroundPhilosophy

An individualized planning process for children withhigh needs and their families that wraps neededservices around them, resulting in a unique set ofcommunity services and natural supports for thepurpose of achieving positive outcomes.

Family-Family-Family-Family-Family-

DrivenDrivenDrivenDrivenDriven

Community-

Community-Community-

Community-

Community-

BasedBasedBasedBasedBased

CulturallyCulturallyCulturallyCulturallyCulturallyCompetentCompetentCompetentCompetentCompetent

Youth-Youth-Youth-Youth-Youth-Guided

GuidedGuidedGuidedGuided

Linguistically

Linguistically

Linguistically

Linguistically

Linguistically

CompetentCompetentCompetentCompetentCompetent

Individualized

Individualized

Individualized

Individualized

Individualized

Jeremy’s StoryJeremy’s StoryJeremy’s StoryJeremy’s StoryJeremy’s Story

Back Together AgainBack Together AgainBack Together AgainBack Together AgainBack Together AgainSystem of Care worksAll I really wanted to do was to be with my family and take care of

them. My mother was in prison and my five siblings and I were placed in thecustody of the state and sent to foster care. I almost immediately began tosteal, not for myself, but for my family and runaway from my fosterplacement. My siblings and I were split up and I wanted to be able to get usall back under the same roof and to be able to provide for my family. InsteadI landed myself into trouble and was sent to live in a residential treatmentfacility.

When my mom was released from prison she was able to get mybrothers and sisters back, but I was still in residential. From a distance Iwatched her struggling to make ends meet and it made me mad. I was toldthat if I was to be reunited with my family, I had to improve my behavior anddecrease the incidents of stealing and being aggressive. My Children’sDivision Case Manager referred my family to the local system of care. Ibegan to meet with my Care Coordinator who helped my mom and I set up ateam of people that could help me reach my goal of being reunified with myfamily. My team consisted of myself, my mom, a couple of my siblings, myaunt, my Care Coordinator and Case Manager, and a Family Peer SupportSpecialist that helped my mom navigate the whole system.

The team and I came up with goals that I could work on. These goalswere realistic and something I felt would actually help me. The team alsohelped my family get the support they needed by using a wide array ofcommunity agencies. They were able to help my mom and siblings securestable housing and even helped my mom find a permanent job as ahousekeeper at a local hotel.

Knowing that my family was okay, I finally felt I could work on myown issues. I’m proud to say that I made it through an Independent LivingProgram and my mom and I are finally reunited. She now has full legal andphysical custody of all six of us kids. We are doing well, and as for me, I am

Currently 19 counties in the Missouri and theCity of St. Louis are sanctioned Local System ofCare sites.

Local Sanctioned System of Care SitesTo become a sanctioned site under Senate Bill 1003 a countyor groups of counties must agree to follow the core valuesand principals of System of Care and to use the Wrap-Around philosophy.

Bringing the pieces together is only the beginning

As a sanctioned System of Care site, all partners have agreed to:Identify children with the most severe needs in theircommunity,Share resources in order to serve these children moreeffectively and efficiently,Provide the Department of Mental Health with data required onall identified children, andWork to address local system barriers and seek assistancefrom the State System of Care Team when these barrierscannot to be overcome at the local level.

The System Partners… Who are they?

YouthFamilies – Family Run Organizations

Children’s DivisionJuvenile Justice

Public School SystemDepartment of Mental Health

(CPS, ADA, and MRDD divisions)Child Advocacy Organizations

Division of Youth ServicesDepartment of Health and Senior Services

Department of Public SafetyLocal Child Serving Agencies

System of Care works

Ben’s StoryBen’s StoryBen’s StoryBen’s StoryBen’s Story

At the beginning of 2005, my wife and I were at acrossroads with our son, Ben. We love our son somuch, but we were at the end of our rope and thoughtthe only option left to us was to give the state custody ofour son. Ben lives with bi-polar disorder and Aspergerssyndrome, which are serious emotional disturbances thatwithout proper treatment and supports causes greatdisruption in our family life.

In January of 2005 Ben’s school crisis counselorreferred us to the System of Care. Over the time wehave spent working with the System of Care team, wehave made great strides in helping our son and ourfamily learn to live in harmony. Our family started outin an intensive program meeting three days per week.Since then we have made tremendous progress and nowBen meets with his Care Coordinator one time per week.

The Care Coordinator helped us to learn how to bea true partner in the decisions that affect our son. Wewere able to work together to set up a team that includesus, the Care Coordinator and appropriate schoolpersonnel. Ben is doing much better now in school andat home. The System of Care has helped us keep our sonat home, where he belongs.

Our Son, BenOur Son, BenOur Son, BenOur Son, BenOur Son, BenHelping Youth to Improve Their Self

The youth and children served using the System of Care have many challenges and strengths. Bypartnering with child serving agencies around the community, we are able to serve the needs ofthe entire family and to build resilience and promote recovery.

System of Care works because it is a process that combines communityinvolvement with community partners.Helping Youth to Improve Their Self

KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:RRRRReduced costs due to fewer days ineduced costs due to fewer days ineduced costs due to fewer days ineduced costs due to fewer days ineduced costs due to fewer days ininpatient care.inpatient care.inpatient care.inpatient care.inpatient care. The average reduction in per-childinpatient hospital days from entry into services to 12months translated into an average per-child costsavings of $2,776.85.

KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:Decreased utilization of inpatient facilities.Decreased utilization of inpatient facilities.Decreased utilization of inpatient facilities.Decreased utilization of inpatient facilities.Decreased utilization of inpatient facilities.The percentage of children who used inpatient facilitieswithin the previous 6 months decreased 54 percent fromentry into systems of care to 18 months after systems ofcare.

KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:Mental health improvements sustained.Mental health improvements sustained.Mental health improvements sustained.Mental health improvements sustained.Mental health improvements sustained.Emotional and behavioral problems were reduced signifi-cantly or remained stable for nearly 90 percent of childrenafter 18 months in systems of care.

KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:Suicide-related behaviors wereSuicide-related behaviors wereSuicide-related behaviors wereSuicide-related behaviors wereSuicide-related behaviors weresignificantly reduced.significantly reduced.significantly reduced.significantly reduced.significantly reduced. The percentage ofchildren and youth who had deliberately harmedthemselves or had attempted suicide decreased 32percent after 12 months in systems of care.

Key

Ou

tcom

es a

re n

atio

nal

sta

tist

ics

prov

ided

by

the

Su

bsta

nce

Key

Ou

tcom

es a

re n

atio

nal

sta

tist

ics

prov

ided

by

the

Su

bsta

nce

Key

Ou

tcom

es a

re n

atio

nal

sta

tist

ics

prov

ided

by

the

Su

bsta

nce

Key

Ou

tcom

es a

re n

atio

nal

sta

tist

ics

prov

ided

by

the

Su

bsta

nce

Key

Ou

tcom

es a

re n

atio

nal

sta

tist

ics

prov

ided

by

the

Su

bsta

nce

Abu

se a

nd

Men

tal

Hea

lth

Ser

vice

s A

dmin

istr

atio

n.

Abu

se a

nd

Men

tal

Hea

lth

Ser

vice

s A

dmin

istr

atio

n.

Abu

se a

nd

Men

tal

Hea

lth

Ser

vice

s A

dmin

istr

atio

n.

Abu

se a

nd

Men

tal

Hea

lth

Ser

vice

s A

dmin

istr

atio

n.

Abu

se a

nd

Men

tal

Hea

lth

Ser

vice

s A

dmin

istr

atio

n.

Sarah’s StorySarah’s StorySarah’s StorySarah’s StorySarah’s Story

A free spirit with her own desires and dreams of designingclothing, Sarah thrives on her creative side. She has a great gift fortaking vintage clothing and jewelry bought at thrift stores andturning them into unique creations that draw praise and attentionwherever she goes. This talent is her outlet to the world, a worldthat in the winter of 2003 she wanted to leave.

It was in the winter of 2003 when Sarah became suicidaland was not attending school. She was referred to the System ofCare by a community support provider.

Before entering the System of Care, Sarah was a victim ofbullying and teasing at school. She would often cut herself so thatthe pain of loneliness and sadness would go away. She was notcomfortable around other youth and did not want to approachpeers for fear of being teased and bullied. In an attempt to fit intodifferent groups at school, Sarah began to experiment with herattitude and clothing. She discovered she had a knack foraccessorizing, designing, and creating clothing and jewelry. As herconfidence grew, she noticed others around her beginning to takenotice of her unique creations.

With the support of her individualized treatment team, shecontinued to let her creative side shine through. She has expandedinto other outlets such as poetry, journaling, short stories, anddrawing. Sarah began to make friends who enjoyed her outgoingcreative spirit. She has now graduated from the program andcontinues to thrive.

The Creative SpiritThe Creative SpiritThe Creative SpiritThe Creative SpiritThe Creative SpiritHelping Youth to be Successful in School

Helping Youth to be Successful in SchoolChildren spend many hours oftheir life in school, so workingin partnership with the schoolsis crucial to helping familiesand youth.

Working together in a truepartnership we are all makinga difference one life at a time.

“With support and“With support and“With support and“With support and“With support andencouragement from myencouragement from myencouragement from myencouragement from myencouragement from myschool counselor and myschool counselor and myschool counselor and myschool counselor and myschool counselor and mycare coordinator, I havecare coordinator, I havecare coordinator, I havecare coordinator, I havecare coordinator, I havelearned that I am some-learned that I am some-learned that I am some-learned that I am some-learned that I am some-body, not a nobody.”body, not a nobody.”body, not a nobody.”body, not a nobody.”body, not a nobody.”

~Sarah~Sarah~Sarah~Sarah~Sarah

KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:SSSSSchool attendance improved.chool attendance improved.chool attendance improved.chool attendance improved.chool attendance improved.The percentage of children with regular schoolattendance (i.e., 75 percent of the time or more)during the previous 6 months increased nearly 10percent with 84 percent attending school regularlyafter 18 months in systems of care.

KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:SSSSSchool achievement improved.chool achievement improved.chool achievement improved.chool achievement improved.chool achievement improved. Thepercentage of children with a passing performance(i.e., C or better) during the previous 6 monthsincreased 21 percent with 75 percent of childrenpassing after 18 months in systems of care.

St. Charles County System of Care School Statistics(as reported by Parent to Care Coordinators- average of all kids served in 2004-2005)

♦♦♦♦♦ 97.5% of children served areparticipating in a goal-oriented education plan;

♦♦♦♦♦ Children in the Partnership with Familiesprogram attended 86% of allpossible school days;

♦♦♦♦♦ 82.5% of children served did not receiveout-of-school suspension within the 1st semster.

Based on F

Y 2005 St. C

harles County System

of Care Service

Statistics and Local Site D

ata for April - A

ugust 2005

Based on F

Y 2006 P

artnership with Fam

ilies, St. Charles C

ounty System of C

areService Statistics and F

Y 2005 M

issouri Children’s D

ivision Statistics of cost per month

The cost per month of serving a child in the St. Charles County System ofCare, Partnership with Families (PWF) versus out-of-home placement...

Brenda and Sam’s StoryBrenda and Sam’s StoryBrenda and Sam’s StoryBrenda and Sam’s StoryBrenda and Sam’s Story

A Parent’s ThanksA Parent’s ThanksA Parent’s ThanksA Parent’s ThanksA Parent’s Thanks

Thank God for the System of Care transformation in my life. At the time theSystem of Care came into my life, I was mad at the world and not to trusting of anyone.

When I met my Care Coordinator, she appeared so young and so happy all thetime. She was thrilled about getting my son and me back together again. I wanted tobelieve and feel as thrilled as she was, yet feeling it was another program to complete,along with all the rest I was already doing.

The System of Care truly opened the door in working with the Children’sDivision. They weren’t the enemy anymore. They wanted me to succeed as much as myfamily treatment team did.

The first few meetings I wasn’t able to see my son, on his birthday I could onlydrop off presents and at Christmas my son and I exchanged gifts in the back of the CareCoordinator’s car. These were the hard times but as things became more organized Ibegan to have regular meeting times with my son. The team was even able to help myson realize one of his dreams, playing baseball. Team members helped find a team andmade sure he had all his equipment. I took him to and from practice and games. Thatwas fun and brought me and my son closer together.

I used to be against Children’s Division and how they seemed to use my son asa bargaining chip, to have me do exactly as they wanted, with so little time to completeeverything. Yet things really began to change with our treatment team to support us.They made me confident and the laughter and joy appeared on my face once again.They helped me understand that the meetings were not something to fear and feel sohelpless and defeated. As time passed I trusted in who sat at the table in meetings andeveryone had a common goal (goal = to have my son back once again).

My team consisted of our Care Coordinator and Family Peer SupportSpecialist, my counselor, Our Little Haven Residential Staff, Children’s Division CaseManager, my child’s Guardian Ad Litem and my friends who knew me as a person andnot just a case. The team became my strength and my family whom I enjoyed beingwith. They were my cheering section.

My Care Coordinator and Family Support Specialist not only supported mebut became supports I could call anytime and just talk, as well as help me with needsand resources like bus tickets, clothing, gas deposits and the list goes on. They not onlyhelped me with resources but medicine and everything I needed.

After the judge awarded me custody of my son, everyone involved was invitedto my apartment for a party. It was really nice and a wonderful place for friends to be alltogether.

Today I have my son back, my goals completed and my self-esteem at the top!We have been reunited a year and a half and we have our own apartment. WOW!Now that’s a small miracle by itself.

I still call my Care Coordinator to ask about programs that may help my son orjust to talk. She has always been there. She is still a very strong source of support. Theteam overall became friends, people whom I respect and truly care about. I feelprivileged to have had such a great team.

Thank you to thewhole System of Care crewand my counselor. Together mylife is full and my son and I canonly go up “to the stars”.

I Love You All!!Brenda

Helping youth become productivemembers of the community.

The cost per day of youth who are in the custody of the juvenileThe cost per day of youth who are in the custody of the juvenileThe cost per day of youth who are in the custody of the juvenileThe cost per day of youth who are in the custody of the juvenileThe cost per day of youth who are in the custody of the juvenilejustice system vs. those who are in their community throughjustice system vs. those who are in their community throughjustice system vs. those who are in their community throughjustice system vs. those who are in their community throughjustice system vs. those who are in their community throughthe St. Charles County Sytem of Care.the St. Charles County Sytem of Care.the St. Charles County Sytem of Care.the St. Charles County Sytem of Care.the St. Charles County Sytem of Care.

1 out of 101 out of 101 out of 101 out of 101 out of 10children in thechildren in thechildren in thechildren in thechildren in the

United States has aUnited States has aUnited States has aUnited States has aUnited States has aSerious Emotional DisturbanceSerious Emotional DisturbanceSerious Emotional DisturbanceSerious Emotional DisturbanceSerious Emotional Disturbance

according to theaccording to theaccording to theaccording to theaccording to theSurgeon General’s reportSurgeon General’s reportSurgeon General’s reportSurgeon General’s reportSurgeon General’s report

KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:Significant reduction of placementsSignificant reduction of placementsSignificant reduction of placementsSignificant reduction of placementsSignificant reduction of placementsin juvenile detention and other securein juvenile detention and other securein juvenile detention and other securein juvenile detention and other securein juvenile detention and other securefacilities.facilities.facilities.facilities.facilities. Children and youth who were placedin juvenile detention or other secure facilities withinthe previous 6 months decreased 43 percent fromentry into services to 18 months after enteringsystems of care.

KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:KEY OUTCOME:Reduced arrest results in per-child costReduced arrest results in per-child costReduced arrest results in per-child costReduced arrest results in per-child costReduced arrest results in per-child costsavingssavingssavingssavingssavings..... From entry into systems of care to 12months after entry, the average reduction innumber of arrests per child within the prior 6months translated into an average per-child costsavings of $784.16.

Based on F

Y 2006 P

artnership with Fam

ilies, St. Charles

County System

of Care Service Statistics and F

Y 2004

Missouri C

hildren’s Division Statistics of cost per day

$150.77

$116.84 $113.56

$100.00

$59.25

$25.00

$0.00

$20.00

$40.00

$60.00

$80.00

$100.00

$120.00

$140.00

$160.00

HighSecurity

MediumSecurity

LowSecurity

JuvenileDetention

DayTreatment

PWF (forentirefamily)

Missouri SOC Sites Contact with Criminal Justice System: Youth Report

56%64%

28%

46%

0%

10%

20%

30%

40%

50%

60%

70%

Arrests (N = 68)* On Probation (N = 58)

% o

f You

th

Baseline6-months

For Further Information, on theMissouri Comprehensive Children’s

Mental Health System and localSystem of Care sites please call:

314.877.0372

Please note: All stories within these pages are truestories of triumph within the Missouri local Systemof care sites. The names of the youth and familieshave been changed and stock photos used to protecttheir privacy and maintain confidentiality.

This booklet was produced through a partnership of Missouri State Department of Mental Healthand Local System of Care Sites. Funding for this publication was provided by

Youth inTransition-St. Louis System of Care and the Substance Abuse and Mental HealthServices Administration. Creation and Design was provided by Crider Center for Mental Health.