Youth and Family Training Institute

1
Youth and Family Training Institute
Overview
2
Presidents New Freedom Commission found

• Unmet need (as much as 75 do not receive special
  mental health service)
• and fragmentation
• and the lack of a comprehensive, systematic
  approach to childrens mental health

3
Subcommittee on Children and Families

• Expanded the focus of the Commission which was on
  children with serious emotional disorders
• To include intervention for children at risk for
  mental disorders
• As well as prevention of mental health problems
  and promotion of positive mental health for all
  children

4
Vision

• Based on a System of Care approach
• Calls for a broad array of services and support
  in a childs home, school and community
• In partnership with the family and consistent
  with the culture, values, and preferences of the
  child, youth and family.

5
Recovery and Resilience

• People who are involved in supportive social
  relationships experience benefits in terms of
  health morale and coping
• Strengthening interpersonal and community ties is
  a resilience and development promoting strategy

6
OMHSAS Call to Action

• We spend 1 billion on childrens behavioral
  health services
• We have little more than anecdotal evidence that
  our efforts result in desired outcomes
• We have a wealth of talented, committed people
  with a passion for change.

7

• Transformation Objective
• Transform the childrens behavioral health
  system in Pennsylvania to a system that is family
  driven and youth guided

8
Establishment of Child-Family Teams

• Establish an Institute to provide training,
  support and monitoring of Youth and Family Teams
• Develop mechanism for Medicaid payment of Youth
  and Family Team process
• Begin process of implementing Youth and Family
  Teams throughout the Commonwealth

9
The Process

• Request for Applications
• Three proposals
• Review Team composed of youth, family, and other
  stakeholders
• Team met with the three applicants
• Selection of the University of Pittsburgh

10
Is it really the University of Pittsburgh?
A partnership of the University of Pittsburgh,
family organizations, youth organizations,
providers, community organizations and managed
care organizations.

• University of Pittsburgh
• Office of Education and Regional Programming
  (OERP), Department of Psychiatry, Office of
  Child Development, Department of Social Work
• Pennsylvania Families, Inc. (PFI)
• National Alliance for the Mentally Ill (NAMI-PA)
• Western Pennsylvania Partnership for Family
  Support
• Allegheny Family Network (AFN), chapter of the
  Federation of Families
• Youth Outreach Union (YOU)

11
Is it really the University of Pittsburgh
(cont.)?
Pennsylvania Community Providers Association
(PCPA) CASSP Coordinators County
Administrators Western Psychiatric Institute and
Clinic of UPMC Adelphoi Village (Westmoreland
County), provider of MST Allegheny County System
of Care Initiative Beaver County System of Care
Initiative Community Care Behavioral Health
Organization (MCO for 35 counties) ..More to
Come!
12
Key Definitions

• Family/family member A person or persons who
  are directly responsible for raising a child or
  children with mental health challenges. Usually
  a mother, father, legal guardian or
  grandparent.
• Youth/child/young adult An individual between
  the ages of 0-25 with mental health issues.

13
So what is the problem?

• Do you actually know what you are going to do
  or are you making this up as you go?
• 
  Father of an adolescent in an inpatient family
  session
• Im glad youre happy that my rating scales
  have improved, but my life sucks.
• 
  A 23 year old said to her psychologist
• Train me so I can do without you.
• 
  Mother of a 10 year old with severe ADHD to
  their case manager

14
Current System
15
What is the Solution?

• High Fidelity Wraparound
• Not current version of PA wraparound!
• A process for supporting youth and families with
  co-occurring disorders
• Defined by National Wraparound Initiative
• 10 principles
• Four phases (90 skill set training, coaching,
  facilitation and evaluation)
• Needs, self efficacy, natural supports and an
  integrated plan

16
What is the Solution (cont)?

• Principles of Wraparound
• Family Voice and Choice
• Team Based
• Natural Supports
• Collaboration and Integration
• Community Based

• Culturally Competent
• Individualized
• Strengths Based
• Persistence
• Outcomes Based and Cost
  Responsible

17
JAIMIE
18
JAIMIE (cont.)
19
JAIMIE (cont.)
20
JAIMIE (cont.)
21
JAIMIE (cont.)
22
JAIMIE (cont.)
23
JAIMIE (cont.)
24
The Youth and Family Training Institute will

• Teach facilitators how to help youth and families
  decide for themselves what pieces belong in their
  puzzle, how to organize and coordinate the
  pieces, and how to bring all of the childs and
  familys unique puzzle pieces together so that it
  belongs to them.
• Equip youth and families with the skills needed
  to design, assess and monitor their own puzzle.
• Assure that facilitators have the ongoing
  knowledge and insight to address all puzzle
  pieces while assuring fidelity to the model.

25
The Youth and Family Training Institute
will(cont.)

• Create an evaluation and monitoring function to
  continually assess the quality of each childs
  puzzle and the impact it is having on improving
  the lives of the youth and family.
• Share relevant information about fidelity,
  outcomes, services and costs with the counties
  and with OMHSAS to effect change.

26
Implementation
1. Start-Up Activities (November 2007-April 2008)

• Hire Vroon VanDenBerg train the trainer model.
• Recruit, train and prepare Advisory Board.
• Hire, train and prepare Institute staff (50
  youth/families) including director, trainers
  and evaluators.
• Provide High Fidelity Wraparound orientation
  and training for Pitt/WPIC, OMHSAS staff,
  CASSP Coordinators, County Administrators, Youth
  and Family Leaders.
• Develop county readiness assessment/RFP process
  and select first eight demonstration
  counties.
• Implement High Fidelity Wraparound in
  demonstration counties.

27
Implementation (cont.)
2. On-Going Activities (May 2008-2012)

• Actively partner with Youth and Family
  Organizations and individuals to develop
  partnerships and training opportunities.
• Train, coach and credential wraparound
  facilitators.
• Develop and implement a system that assures
  that services are continually evaluated to
  support fidelity to the model, areas are
  identified for improvement and outcomes are
  assessed.
• Roll-out High Fidelity Wraparound model to all
  67 counties.
• Engage and support System Partners in the
  transformation process.
• Work hand in hand with OMHSAS to create policy
  and funding recommendations.

28
Future

• Access to best practice research from
  University of Pittsburgh Department of
  Psychiatry, other Pennsylvania university
  researchers and nationally recognized
  experts.
• Create the first true wraparound model that
  incorporates relevant aspects of the medical
  model.
• Redefine hiring criteria for key positions.
• Time Sensitive and other NIMH grants (for
  evaluation and best practice).
• Technology based training (video conferencing
  etc.).
• Other grant/funding opportunities.

Other Opportunities
29

• On this earth not alone we stand
• Outstretched arm and upturned hand
• Never knowing when the shakes steady
• And till now, we have seldom seen.
• I will go if you go with me
• Understand I will wait for thee
• Ill try to catch up if you move quickly
• If the rain does blow.
• Indian Moon by State Radio