Help me understand the types of mental health services available
The services listed below are provided by Community Mental Health to children and youth with mental illness, serious emotional disturbance or developmental disabilities. The services provided to you and your family are determined by an initial intake assessment, development of an individualized plan of service and what is decided to be “medically necessary." The descriptions below will give you an idea of the services that may be helpful to you and your family. Although there is a large array of services, the particular services provided to you and your family will be discussed during the development of your family-centered, youth-guided individualized plan.
For more information on mental health services please see the sections on Mental Health Services for Children and Intellectual and Developmental Disability Services in the Michigan Medicaid Provider Manual.
Outpatient Child Therapy
Sometimes when children and adolescents have emotional or behavioral problems, meeting with a counselor to learn new skills to understand and deal with thoughts and feelings can help them do better at home and in the community. Based on the assessment and discussion with the child and family, things like goals, treatment approaches and how often to meet are decided.
Outpatient Family Therapy
Outpatient family therapy is another option that counselors may use when it’s important for the family to work together on a child’s behavior. In this way, the whole family can work together on treatment goals.
Home-Based services are more flexible because the services occur in the home and community and can be scheduled more often than is usually true of outpatient counseling. Sometimes Home-Based services are recommended when a child and family have more intensive needs and services are focused on both the child and the family. The goals for Home-Based services, how often sessions are scheduled and what approaches will be used are decided together by the child, family and Home-Based worker. Home-Based services are designed to support the child to remain in their family home. Home-Based services also may be used when children and families who have been separated are working on being reunified.
When children are taking psychotropic medications as part of their treatment plan, they will meet regularly with a medical provider to discuss whether the medications are helping enough and what problems, if any, the medications might be causing. These medication reviews are scheduled every few weeks or months depending on the child’s current situation. Because child and family input is important and children aren’t allowed by law to consent to medications, parents or guardians need to attend these appointments with children.
Respite services provide relief from the daily stress and care demands of a child with behavioral challenges. Respite care for a child can be provided in the home or in another setting to support a parent who needs relief. Respite services can be scheduled on an hourly basis, or overnight, and can be added to a child’s comprehensive treatment plan.
Community Living Support (CLS)
CLS services are used to help a child or youth build his or her skills to be more successful in the community. CLS services are provided by aides who can help teach skills of activities of daily living (for example personal hygiene), social skills or other things that are part of the child’s care plan. CLS is also used with older children or adolescents to build skills so that they can become more independent.
Wraparound is a planning process used when children and families need a higher level of support to achieve their goals and when the child is at risk of not being able to stay at home or in the community. The Wraparound process starts with the Wraparound facilitator bringing together the child, his or her family and other people the family wants to involve - for example, a special education teacher or a foster care worker. The Wraparound team identifies the child and family’s strengths and needs and decides how to help them meet their goals. The Wraparound team meets at least once a month to make sure all parts of the plan are going well and to adjust the plan if needed. Wraparound usually lasts several months to a year based on the progress in meeting the goals. When it is time to finish the Wraparound process, the team will figure out what service providers will continue to work with the family - for example outpatient counseling, Community Living Supports (CLS) and psychotropic medication follow-up.
Case management services are provided when a child has emotional and behavioral needs and his or her family could use help connecting to supports and programs, like medical services, school supports or financial assistance. A case manager works with a family to figure out what supports are most needed and helps them connect to those services. They also help the family learn how to advocate for themselves.
Parent Support Partner (PSP)
Parent Support Partners have personal experience parenting a child with emotional or behavioral needs and are experts at helping families to be empowered during the treatment process and to build confidence and skills to assist their child to improve. Parent Support Partners work with families as identified in their child’s family-centered, youth-guided, individualized treatment plan.
Applied Behavior Analysis
Applied Behavior Analysis is used in young children with autism to develop positive social skills and in older children with autism to help deal with challenging behaviors. Applied Behavior Analysis (ABA) has been studied and used for many years for children with autism. ABA is a way of figuring out the factors that affect a child’s behavior so that a plan to change behavior can be successful. It includes looking at situations a child may be experiencing before he or she does something, like hitting or running away. It also includes looking at how responses by adults after a behavior can make that behavior more or less likely in the future. ABA can be used at home, in school and during treatment sessions. It is important for all the individuals working with the child to be following a consistent plan. ABA providers have gone through specialized training in ABA and in helping teams to work together.
Inpatient Psychiatric Hospitalization
Inpatient psychiatric care is used when a child or adolescent with mental illness or serious emotional disturbance needs 24/7 care because they are at a high risk of harming his/herself or someone else. Treatment usually includes individual therapy, group therapy, and medication treatment. Families are involved in treatment. Sometimes school services are available on site. For children who have Medicaid insurance, the decision about whether inpatient treatment is medically necessary is usually made by Emergency Services at the local Community Mental Health for the child’s legal county of residence. If a child is placed out of home in a different county, the county of legal residence will have to work out the best way to assess the need for inpatient care.
Occupational Therapy / Sensory Integration Therapy
These therapies help children build strength and coordination for day to day tasks and can help when a child has problems with how their senses react to the world around them, for example when children are extra sensitive to touch or noise. The goal of occupational therapy is to help children function better over the long term. Occupational therapy is provided by trained professionals for a specific period of time. A doctor’s referral is needed for occupational therapy assessment and treatment.
Speech, Hearing, and Language
Children who are struggling with making letter and word sounds, understanding language, or expressing themselves might get speech, hearing and language services for a specific period of time. A doctor must refer for assessment and treatment, and the services must be determined to be needed for the child to function (medical necessity). Services might be provided to the child alone or in a group, depending on the child’s needs.
Evidence Based Practice (EBP)
Evidence Based Practice is a general term used for treatment that has either been proven effective by research studies, or seems very likely to be useful based on the best opinion of experts in the field. Across Michigan, treatment providers are expected to use Evidence Based Practice.
Substance Use Disorder (SUD) Services
Substance Use Disorder Services help people struggling with alcohol or drug addiction. It may include a number of interventions that are decided according to the individual’s need. When someone also has a mental health disorder it is addressed when developing the treatment plan.
Youth Peer Support (YPS)
YPS is designed to support youth with a serious emotional disturbance through shared activities with the Youth Peer Support Specialist. The goals of YPS include empowering youth, developing skills to improve overall functioning and quality of life and working collaboratively with others involved in delivering the youth’s care. YPS services is are provided by a trained youth peer support specialist, one-on-one or in a group, for youth who are resolving conflicts, enhancing skills to improve their overall functioning, integrating with community, school and family and/or transitioning into adulthood.