By Zhen Wang, Wisconsin Health Fellow
Children’s mental health: Building systems that work
Panelists discussed a new care model for children with mental health needs in New Jersey during “Children’s Mental Health — Building Systems that Work” at Health Journalism 2024 in New York City.
Elizabeth Manley, senior advisor for the Innovations Institute at the University of Connecticut, explained that New Jersey redesigned its public behavioral health system in the early 2000s to offer early and flexible access to behavioral care.
Manley, formerly the assistant commissioner for the New Jersey Children’s System of Care, highlighted that in the 1990s, barriers to accessing needed mental health treatment often led parents to relinquish custody to child protection or juvenile justice systems.
She said that the reformed system provides behavioral care to all children in need. The new model moved initial access to behavioral health services away from child protection and juvenile justice systems, creating a seamless access point for families. The funding structure was reorganized to draw from restrictive settings and leverage Medicaid funding.
This allowed New Jersey parents to call a 1-877 number 24/7 for help with their children’s behavioral health needs, with a response team arriving in one hour.
Panelist Dr. De Lacy Davis, a father of four adopted children, shared a personal experience where a clinician stabilized a mental health crisis of one of his children after he dialed 1-877, with care services delivered the next day.
He said this face-to-face care approach saves lives and prevents overmedication and criminalization of children, particularly for those in Black and brown communities.
Davis, executive director of the Alliance of Family Support Organizations, noted that the alliance collaborates with care management organizations to support, educate, and advocate for families with complex needs.
Panel moderator Christine Herman, an independent reporter and editor, underscored the importance of family support as a non-therapeutic component of the system of care.
Noting people are ready at “different times for different things,” Manley added that a family-led peer support system prepared families for crises.
She said that the New Jersey model prioritizes home-based care, but when homes are unsafe due to gun violence, partnering with law enforcement is crucial, and interventions must be evaluated on a case-by-case basis.
The New Jersey model, which includes youth with developmental disabilities or substance use challenges, has gained bipartisan support. Manley noted the state’s success in keeping 97% to 99% of young people at home due to mobile response and stabilization over the past 10 years, reducing the use of out-of-home treatment and residential settings.
Manley credited the success to the young people and their families who drive innovation and shape the system’s evolution. She said that the involvement and feedback from parents early on have been instrumental in refining and reforming the system.
She concluded, “It’s certainly the truth in my experience, and it’s been the truth in New Jersey’s experience.”
Zhen Wang is an independent journalist based in Madison, Wis. She is a 2024 AHCJ-Wisconsin Health Journalism Fellow.
