Albany County, New York received funding from 2004 to 2010 under a grant initiative from the Center for Mental Health Services (CMHS) of the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop a local system of care.

The Systems of Care initiative, administered by the Child and Family Branch of CMHS, was launched in 1993 and is the largest child mental health services initiative ever funded. Grants have been awarded to more than 150 communities to support the development of local systems of care for children with serious emotional disturbance. A system of care is a coordinated network of community-based services and supports that are organized to meet the challenges of children and youth with serious mental health needs and their families. The system of care in Albany County (Families Together in Albany County) was a partnership between the Albany County Department for Children, Youth, and Families and Families Together in New York State, Inc.

Evaluation & Research

CHSR led the congressionally-mandated, mixed-methods evaluation of this local initiative. CHSR's Albany County evaluation was part of the national evaluation of all system of care communities, coordinated by ICF Macro, and Walter R. McDonald Associates. The study components included:

• The Descriptive Study collected demographic characteristics, social and functional characteristics, mental health diagnoses and presenting problems on all children/youth entering the system of care. Descriptive information was collected on over 1,700 youth referred into the system of care.
• The Longitudinal Child and Family Outcome Study used a combination of questionnaires and standardized instruments regarding: children’s emotional and behavioral status, strengths, educational performance, criminal justice system involvement, living environments, caregiver strain, family functioning, service utilization, and child and family satisfaction with services.  Using computer-assisted software, 236 families and youth were interviewed in-person at 6-month intervals over the course of the project. 
• CHSR was an integral part of the local initiative as a resource for continuous feedback on process and outcomes. Two part-time family interviewers conducted field interviews over the course of the project.
• Process measures, obtained from key informant interviews, focus groups, and surveys, supplemented the national evaluation.

Program Development

Systems of care are complex system transformation and service integration initiatives. Working with the community to develop a logic model is an effective way to bring together diverse groups around a common goal – to organize their planning, implementation, and evaluation strategies. This process utilizes the Theory of Change to help participants understand how the underlying assumptions and strategies that guide local system development are critical to producing changes in services and supports that are expected to lead to improvements for the community and its residents. The “final” logic model is presented here. Ideally, a logic model should never be considered “final.” Rather, it is a tool for ongoing discussion, monitoring progress, continuous quality improvement, and a vehicle for making midcourse corrections throughout an initiative.

For more information, contact Rose Greene.