Collaboration with Mental Health: Insights from an "Outsider"

Vol. 4, No. 2
May 1999

Collaboration with Mental Health: Insights from an "Outsider"

Today it is widely accepted that families and children benefit when DSS and mental health systems collaborate. But what does that mean to you? What, specifically, can child welfare workers do to achieve and improve this collaboration?

To get the perspective of someone who really knows what it's like to work in both these systems—simultaneously—Practice Notes contacted Jay Taylor. A psychologist employed by Cleveland Center, Cleveland County's mental health center, Taylor has an office located in Cleveland County, North Carolina Department of Social Services (DSS). From this unusual vantage point, he sees the challenges faced by two systems charged with serving many of the same families.

PN: What do child welfare workers need to know about the mental health system in North Carolina?

Mental Health (MH) is undergoing flux at the state level: developing, changing, and adapting programs in different areas.

There are 40 different area programs. Each does business in a somewhat different way. Because area programs tend to be different from one another, it's hard to make suggestions or give advice for working with MH that will be applicable statewide.

Still, it would be very useful if every worker knew when and how to make an appropriate referral to MH. They should understand the criteria for treatment and recognize the guideposts that indicate treatment might work.

But since things are slightly different across the state, I'd recommend DSS invite MH folks into their agencies to do inservice training on this subject—to tell them about referrals, and about what resources are available to them.

As a result of this, DSS workers should experience less frustration, and MH folks will get higher numbers of viable referrals. For example, they'll get fewer requests to evaluate whether someone can be a successful parent. This seems simple, but it's not.

PN: What are some of the trends affecting MH that child welfare workers need to know about?

DSS social workers sometimes have difficulty recognizing or understanding that MH systems are trying to do more with less—the traditional ways of treatment are changing. Specifically, MH agencies are increasingly recognizing the value of group therapy formats to affect change for clients. This is especially true for the problems that confront families DSS sees. There are a lot more parenting, relationship, post-trauma, and skill-building groups.

Another one of MH's biggest challenges is finding ways of dealing with the pervasive deficit of social skills. To deal with this and other problems in the people we see, MH centers are trying to establish more efficient, non-clinic based ways of promoting MH—more in line with community centers, family resource centers, etc. MH is beginning to recognize these as informal treatment modalities.

PN: What effect does this have on child welfare social workers?

I think it affects case planning the most. It used to be that social workers could more or less count on the fact that there'd be openings for clients they referred for individual therapy. That's not so true anymore.

Another big movement in MH is toward more family-centeredness, more family autonomy and decision making. Actually, this is something DSS's and MH centers will find in common, especially with DSS initiatives like FFK (Families for Kids in North Carolina) and Challenge for Children and MH initiatives like CAP-MR and NC-FACES (which bring families in as partners in planning and decision making). The family-centered approach could be an important point of contact between the two systems.

PN: What do you think the future of the MH/DSS relationship looks like, especially for line social workers in DSS's?

When working with MH, DSS workers will continue to face difficulty regarding legal and confidentiality issues. It is important for them to understand that MH isn't trying to be difficult, they're trying to comply with increasingly complex guidelines. When social workers see them as making the rules up rather than just complying with them, the friction increases.

I also think that as time goes on, DSS workers will be expected to really understand how other systems work. The more you know about the MH systems in your area, the more you'll be able to help the families you serve.

PN: Do you have any parting words of advice?

I'd recommend line workers get to know somebody at your local MH center you can call regarding particular cases, referrals, resources, etc., someone you can call and just pick his or her brain. It would be ideal if every child welfare worker had one MH worker they could call if they had a question.

Also, it may help to remember that both systems are trying to do more with less. One solution is to share resources.