The mental health system is particularly hard to navigate for clients such as emotionally disturbed children, who often have complex, multiple treatment needs. Even when eligible for a program, these children are likely to receive narrowly focused services that fail to address many of their problems. For example, a child may receive weekly clinical therapy counseling that focuses on bolstering self-esteem but does not address specific problems such as panic attacks. Some families who fail to find adequate treatment in community-based settings have been forced to relinquish custody of their children to qualify them for residential services operated by DPRS, the Texas Youth Commission, or county juvenile justice courts. In 1995, about 250 Texas families who were desperate for help and had used up all their insurance benefits took this step.
Some promising initiatives call for collaboration at the state and local levels.
This arrangement requires local agencies to make collective decisions about how money is spent and what services will be provided, decisions they formerly made separately. Initiatives like Virginia's Comprehensive Services Act and the Franklin County, Ohio Kids in Different Systems project pool funding from state and county agencies to provide more flexible services. Both the Ohio and Oregon projects provide individualized, community-based services for children in or at risk of being placed in residential care. The Dawn Project in Marion County, Indiana uses flexible funding to provide a variety of mental health services to more than 100 children and their families. A nonprofit company, Indiana Behavioral Health Choices, manages the project, which is intended to keep children out of residential treatment.