By Dr. Lisa Durette, MD, DFAPA, DFAACAP
Board Certified Child and Adolescent Psychiatrist, Medical Director at Healthy Minds
This article originally appeared in the May/June 2018 addition of AACAP News, a publication of the American Academy of Child & Adolescent Psychiatry.
Systems of Care (SOC) – the very topic often evokes eye rolls and sarcasm. Home-based, family-focused… where in the core principles of SOC is the child psychiatrist? How is it fathomable that a children’s mental health system can exist without a child psychiatrist? Where in our training are we taught how to navigate the murky political waters entangled with community SOC? Yet the role of the child psychiatrist as advocate for our profession and the youth we serve can significantly impact the community’s mental health system.
Advocacy can take on many forms. Through the course of my own experiences, I have become a committee chair and have been able to advocate for the importance of having a child psychiatrist included in all SOC and local children’s mental health committees. To be fair, SOC is a community-based model which has the flexibility to address the missing elements of our traditional system: childcare, transportation, wraparound care. SOC’s positive attributes come from their family-driven and youth-guided philosophy. It is a strengths-based community model emphasizing interdisciplinary coordination.
AACAP provides many SOC resources on their website. Many states have adopted a SOC model within their jurisdiction. A child psychiatrist was not included amongst the SOC committee makeup in any of the states I researched. However, administrators, including those from juvenile justice, school, and state mental health systems, as well as prescribers were. How is it that we have allowed state and federally-funded care systems for the youth we serve to exclude the child psychiatrist?
Your local SOC committee is an ideal environment in which to practice advocacy. Search your state’s children’s mental health SOC committee makeup online. You will likely find that information within your state’s department of mental health and/or health and human services website. Is there a child psychiatrist included amongst the members? If yes, reach out and understand their role as well as ways in which you can support your community’s work. If no, your next step may be to find the next meeting. In accordance with public meeting laws, meeting agendas are posted in advance of the meetings. Review the agendas – you will likely find items that pertain to your clinical expertise.
Finally, GET INVOLVED! You can typically either call in to the meeting or attend in person. Listen during the first few meetings to identify the players, their roles, and the overall tone and direction of the group. Once you identify a place of entry, begin to participate. Your community’s SOC is funded by YOU as a taxpayer. You have a place at the table. Offer to educate in a supportive fashion. Share AACAP resources, perhaps starting with the Facts for Families. Over the course of time, you can make a significant difference for the youth we serve by including yourself within the committees that determine the funding and provision of children’s mental health within your community.