Transforming Together: Implementation Guide
System of Care The system of care framework emphasizes family-driven, culturally responsive, community-based services delivered early. Beth Stroul (Georgetown University) and Robert Friedman (University of South Florida), working with the U.S. National Institute of Mental Health, developed this framework in the 1980s to better address the unmet needs of children with significant behavioral health challenges. Federal support and strong evaluations (for example, here) helped spread the model nationwide. Whether adopted by behavioral health, education, child welfare, or juvenile justice systems, these efforts all emphasize cross-agency coordination, individualized care plans, and strong family and youth participation (full report, here). California put these principles into law through AB 2083, which requires every county to establish an interagency leadership team and create a service coordination plan for foster youth with complex needs.
Subsequent research confirms that collective impact and systems of care approaches deliver measurable improvements that go well beyond any single agency’s efforts. For example, national evaluations of systems of care show (See Stroul et al., Expanding Systems of Care: Improving the Lives of Children, Youth, and Families, Georgetown University, 2012.): • Improved child and youth well-being : Significant decreases in depression, anxiety, aggression, and trauma symptoms, with concurrent gains in strengths and functioning at home, in school, and in the community. • Better education outcomes : Increases in school attendance and grades, with reductions in suspensions and expulsions. • Reduced juvenile justice involvement : Youth demonstrate lower arrest rates, fewer contacts with law enforcement, and reduced rule-breaking behaviors. • Stronger family outcomes : Families report reduced caregiver strain, greater ability to manage challenging behaviors, and improved financial stability. • Lower use of restrictive settings : Expanded home- and community-based services have led to reductions in costly inpatient and residential placements, allowing reinvestment of resources into more effective supports.
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