4. Services and Supports for Children, Adolescents, Young Adults and Families

4.1 Comprehensive Array of Services and Supports

A comprehensive array of treatment, services and supports that address prevention, early intervention, recovery, and support should be available to children, adolescents and young adults living with brain disorders and their families.  These services should be available through publicly and privately funded service systems.  They should promote resiliency and recovery and include evidence and research based interventions.  There must be effective system coordination and collaboration between systems serving children, youth, young adults and their family.

Services, supports and appropriate accommodations should always be timely, easily accessible, and provided in the least restrictive environment.

They should include, but not be limited to:

Peer support services should be available at all times and at all levels of care.

4.2 School and Campus Based Services

Schools must protect the confidentiality of all students’ mental health related information. 

(4.2.1)  Elementary, Middle and High Schools

Undiagnosed, untreated, and inadequately treated brain disorders significantly interfere with a student’s ability to learn, to grow, and to develop. 

Because children spend much of their productive time in school and services can be integrated into their regular daily routine, NAMI believes thatboth public and private elementary, middle and high schools should provide and/or facilitate and sustain provision of appropriate mental health services, supports, and appropriate accommodations.

In order to assure that coordination of services can be supported and maintained and that families have adequate resources to address their needs, schools should maintain a close connection to the community mental health and primary health care systems. The caseload of school-based mental health providers should be capped at a level that ensures that they can adequately address the needs of students and their families. 

School systems should be adequately funded to provide special education services and to meet the academic and functional needs of all students with brain disorders.   This will require access to both public and private funding for mental health services and supports.  All students should receive an education in the least restrictive setting and in general education classrooms unless their needs can only be met, and are better addressed, in a separate or alternative classroom.  

The bullying that currently exists in far too many of our nation’s schools disproportionately hurts students with disabilities, especially those living with brain disorders.  All schools should develop effective anti-bullying policies so that students with brain disorders are not targeted by bullies or labeled as bullies as a result of symptoms of their brain disorder.

Schools should adopt programs that help educate students, teachers, and the school community about mental illnesses to raise awareness and to eradicate stigma.   

(4.2.2)  College and University-Based Services and Supports

NAMI believes that colleges and universities should provide a full array of services, supports and appropriate accommodations for both campus-based and commuting students.  The array should include mental health evaluations, outpatient treatment, peer support specialists, integrated services for co-occurring brain and substance use disorders, on-campus support and information sources and referrals, a link to the community mental health and crisis intervention service systems, and 24 hour urgent care available daily.  In no case should a student be penalized by dismissal or probation or be denied the right to enroll in a course of study solely because of a brain disorder.

Support, education, and advocacy programs should be available and accessible for students and their families on college and university campuses.  Colleges and universities should include comprehensive information about mental health treatment, services, and supports on their web sites and should notify students and their families about the availability of this information.  They should also share information about the early warning signs of brain disorders and develop effective suicide prevention plans responsive to the high incidence of suicide in young adults aged 15 to 24.

If a student experiences a psychiatric crisis, the college or university should immediately contact the student’s family about the crisis.  Colleges and universities should never use the existence of a psychiatric crisis as grounds to ask a student to leave the school.   Instead, schools should develop appropriate accommodations and supports that appropriately address the needs of students experiencing a psychiatric crisis or recovering from a psychiatric crisis.

Colleges and Universities should adopt programs that help educate students, teachers, and the school community about mental illnesses to raise awareness and to eradicate stigma.   

4.3 Transition Age Services and Supports

NAMI urges the development of effective services that bridge the transition from child to adult for youth living with brain disorders.  These services should be available in our nation’s schools and they must be provided by appropriate community agencies such as post secondary institutions, vocational rehabilitation agencies, housing agencies and other agencies, as appropriate.  Planning for appropriate transition services should begin, at a minimum, by age 14 and should continue as adolescents progress into adulthood.  Barriers to a smooth transition from adolescence to adulthood or to the delivery of effective transition services, such as the imposition of financial criteria or program eligibility requirements, must be eliminated.   

4.4 Educational Programs 

(4.4.1)    NAMI believes that a transformed system of care must be focused on resiliency (increasing protective factors in a child’s life, helping to ensure early identification and intervention, and a child’s ability to bounce back from adversity) and recovery and driven by consumers and families.  A transformed system must also guarantee the widespread availability of free mental health educational programs for children and adults living with brain disorders and families at every stage of the life cycle, and must empower them to be teachers in the education and training of all mental health providers. 

(4.4.2)  Peer-designed and peer-directed educational programs, at every stage of the life cycle, must be valued and promoted as an integral part of the service system. Specific government grants must be made available to support the development and administration of peer-directed programs. In addition, system resources must be made available to develop and evaluate peer educational programs and to establish an evidence base comparable to the rigorous scientific studies conducted by fully funded system-based programs.

4.5 Training and Qualifications for Providers    

NAMI calls for all child-serving professionals to receive training that will help them better understand early onset brain disorders and how to communicate effectively with families about these disorders. Healthcare providers treating children and adolescents with brain disorders should receive as much training as necessary to ensure that they can and will provide evidence and research based treatments and service interventions. 

4.6 Integrated Health and Mental Health Care

NAMI calls on policymakers, providers and public and private funders of healthcare services to place a high priority on addressing the critical need for integration of physical and mental health care.  The causes of health and disease are a product of the interplay or interaction between biological, psychological, and sociocultural factors.  This is true for all health and illness, including mental health and mental illness.

Primary care and mental health care providers working with families, youth and young adults living with brain disorders, should make a commitment to ensure that adequate time, training, and resources necessary to provide appropriate care for children, youth and adults living with mental illnesses are available and accessible when and where they are needed.  They can accomplish this through collaborative practice arrangements, interagency system coordination, and interdisciplinary teamwork.  The integration of physical and mental health care produces better treatment outcomes and overall better health outcomes for children, youth and adults living with brain disorders.

NAMI believes that it is critically important that primary care providers be trained and qualified to recognize the early warning signs of brain disorders, and to screen and evaluate children for mental health treatment needs. Because children and families often visit primary care providers as part of well-child clinical care, this is an important opportunity to identify a child’s need for mental health related treatment and services, at the earliest possible time.

4.7 Family Driven and Youth Guided Services 

All services and supports provided to children living with brain disorders and their families should be youth guided and family driven, with the needs of the child and family dictating the types and mix of services provided. 

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