Transforming Mental Health Care for Children and Their Families Larke Huang American Institutes for Research Beth Stroul Management and Training Innovations, Inc. Robert Friedman University of South Florida Patricia Mrazek Rochester, Minnesota Barbara Friesen Portland State University Sheila Pires Human Service Collaborative Steve Mayberg California Department of Mental Health In April 2002, the President’s New Freedom Commission on Mental Health was created by executive order to study the mental health care delivery system in our nation and to make recommendations for improvements so that individ- uals with serious mental disorders can live, work, learn, and fully participate in their homes and communities. In its report, “Achieving the Promise: Transforming Mental Health Care in America,” the commission provided strate- gies to address critical infrastructure, practice, and re- search issues. This article focuses on the work of the commission’s Subcommittee on Children and Families, de- scribing its vision for mental health service delivery for children and providing suggestions for strengthening com- munity-based care for youths with or at risk of behavioral health disorders. Training, research, practice, and policy implications for psychologists are discussed. Keywords: children’s mental health, systems of care, trans- formation M ental health problems in children and adoles- cents have created a “health crisis” (Satcher, 2000, p. 1) in this country. These problems affect a growing number of youths, they impact these children and their families in all spheres of their lives, and their consequences are costly and often tragic. Recent studies indicate an alarmingly high prevalence rate, with approximately 1 in 5 children having a diagnosable mental disorder and 1 in 10 youths having a serious emotional or behavioral disorder that is severe enough to cause substan- tial impairment in functioning at home, at school, or in the community (Friedman, Katz-Leavy, Manderscheid, & Sondheimer, 1996). The National Institute of Mental Health’s National Advisory Mental Health Council, Work- group on Child and Adolescent Mental Health (2001) con- cluded that “no other illnesses damage so many children so seriously” (p. 1). In conjunction with this prevalence rate, there is an extremely high level of unmet need. It is estimated that about 75% of children with emotional and behavioral dis- orders do not receive specialty mental health services (Rin- gel & Sturm, 2001). Former Surgeon General David Satcher, at his National Conference on Children’s Mental Health, stated that “growing numbers of children are suf- fering needlessly because their emotional, behavioral, and developmental needs are not being met by those very institutions which were explicitly created to take care of them” (Satcher, 2000, p. 1). Yet despite these levels of prevalence and unmet need and the serious impact of mental health problems on the functioning of our children, our nation has failed to develop a comprehensive, system- atic approach to this crisis in children’s mental health. This article highlights the strategies put forth by the Subcom- mittee on Children and Families of the President’s New Freedom Commission on Mental Health to transform men- tal health care for children and families. 1 Although the mandate of the commission focused on intervention for children with serious emotional disorders, the subcommittee expanded this mandate to include inter- vention for children at risk for mental disorders as well as prevention of mental health problems and promotion of Larke Huang, American Institutes for Research, Washington, DC; Beth Stroul, Management and Training Innovations, Inc., Fairfax, Virginia; Robert Friedman, Department of Child and Family Studies, Louis de la Parte Florida Mental Health Institute, University of South Florida; Patricia Mrazek, Rochester, Minnesota; Barbara Friesen, Research and Training Center on Family Support and Children’s Mental Health, Portland State University; Sheila Pires, Human Service Collaborative, Washington, DC; Steve Mayberg, California Department of Mental Health, Sacramento, California. Larke Huang and Steve Mayberg served as co-chairs of the Subcom- mittee on Children and Families that was established as part of the President’s New Freedom Commission on Mental Health; the remaining authors served as consultants to the commission in the area of children’s mental health. This article is based on the findings and recommendations of the Subcommittee on Children and Families. Correspondence concerning this article should be addressed to Larke Huang, American Institutes for Research, 1000 Thomas Jefferson St., NW, Washington, DC 20007. E-mail: lhuang@air.org 1 This article is not the official report of the Subcommittee on Children and Families of the President’s New Freedom Commission on Mental Health. The content of this article reflects the discussions of the subcommittee and its expert consultants. It does not reflect the position of the President’s New Freedom Commission on Mental Health or any agency of the United States Government. 615 September 2005 ● American Psychologist Copyright 2005 by the American Psychological Association 0003-066X/05/$12.00 Vol. 60, No. 6, 615– 627 DOI: 10.1037/0003-066X.60.6.615