Linking to effective care?

Most of the conversations I have with other parents include a description of the services that didn’t work.  Families often wait for a treatment only to find that it just doesn’t match their child’s needs.  It might be the wrong kind of therapy or the wrong school plan.  It might be bad advice (it’s just a phase) or or a poor evaluation.  But whatever it is, it is a waste of time and money.

Most parents start by giving it a try.  You go to the appointment (especially if you’ve waited for weeks) with first hope, then determination. You might wonder why someone thought this was a good match for your child or your family.  You begin to think that even online dating services offer a better profile of what you are getting into.  But you stick with it, usually long after you know that it isn’t what your child needs.

In 2006, Judge Michael Ponser issued a decision in federal court in the Rosie D case.  He had heard weeks of testimony about what was not working for children and families.  A pivotal part of that decision was about assessing children so that they would get services that matched their needs.  He said, “Without a clinically appropriate, detailed assessment of a child, proper treatment is obviously impossible.”

Out of this decision came a plan and that plan included using an assessment tool called the Child Adolescent Needs and Strengths or CANS for short.  The CANS is intended to be filled out with the child’s parents and help inform a process to choose the best course of action for a child and his or her family.  It is crucial to involve families in the assessment process.  After all, they are the experts on their children and their families.  Parents know what works and what has been a dismal failure.

At this point, thousands of clinicians in Massachusetts have been trained to give the CANS assessment.  We know that numerous children and youth have received this assessment (sometimes over and over again) and some clinicians have embraced it while others find it cumbersome.  But what we don’t know is whether it is leading to more services that match the child’s and family’s needs.

And that’s the bottom line.  Parents make sacrifices for their children every day.  They invest their time, money, energy and emotions so that their children will get the care they need.  But they want that care to be effective.  One father I know says that he just can’t believe how ineffective the mental health system is for childen.  He notes that in the business world, some of the programs would go out of business because of poor performance or lack of customer satisfaction.

What we don’t know yet is whether the CANS is leading to more effective services for children with mental health needs and their families.  That’s the real goal.  As we hear of the number of clinicians trained, assessments given and other milestones, let’s not lose sight of it. In the end it’s the only number that matters.

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