Hand in Hand

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Hand in Hand Planting Seeds for Healthy Families

MHMR Of Tarrant County
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Hand In Hand GOALS

• Transform fragmented services into a
  high-quality, sustainable System-of-Care in
  target areas
• Ensure that children with Serious Emotional
  Disturbances (SEDs such as ADHD, Bipolar
  Disorder, Attachment Disorders, Trauma, Autism,
• and Post Traumatic Stress Disorders, etc.) are
  identified early
• Keep children with SED (ages 0-6 years) in
  community settings with their families by
  improving their mental health and school
  readiness
• Empower families to provide leadership in all
  aspects of the system
• Provide culturally and linguistically competent
  community-based services

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Program Overview

• 6year federal 8.3 Million grant through the
  Substance Abuse
• and Mental Health Services Administration
  (SAMHSA)
• Follow up to former System of Care SAMHSA
  grant,
• Community Solutions, which served children and
  youth ages 6-18 years in the City of Fort
  Worth.
• Mental Health Connection serves as the
  Governance Council.
• Program focuses on serving children birth
  through six in Tarrant (with the exception of
  the City of Fort Worth), Parker, Hood, Johnson
  and Palo Pinto counties.
• Program has a major evaluation component that
  utilizes a variety of evaluation instruments
  and is child, family, and community outcomes
  oriented.

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Program Overview (continued)

• Local coordinating groups and family support
  groups will be established to serve in
• Arlington/Mansfield
• Hurst /Euless/ Bedford (HEB)
• Northwest Tarrant
• Hood (Granbury)
• Johnson (Cleburne/Burleson)
• Parker/Palo Pinto Counties (Aledo, Weatherford,
  and Mineral Wells)

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System of Care Service Area
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System of Care

• A coordinated network of comprehensive services
  that meets the mental health needs of children
  and families.
• Core Values of System of Care
• Child centered and family driven with the
  needs of the child and family dictating how
  services will be provided
• Community based with the services, management
  and decision-making of the program made at the
  community level
• Culturally competent with agencies, programs
  and services responsive to cultural, racial
  and ethnic differences within the population
  they serve

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Background
Infant Early Childhood Mental Health HEALTHY
social and emotional development is

• Shaped and influenced by secure relationships
  with the childs primary caregivers in a
  nurturing environment
• Reflected through healthy attachments
• Designed so the child can confidently explore,
  regulate and express emotions in his or her
  natural settings

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Healthy Infants Toddlers

• HEALTHY social and emotional development is
  demonstrated by infants and toddlers ability
  to
• Form close, secure relationships
• Experience, regulate and express emotions
• Explore the environment and learn in the context
  of
• family, community and cultural expectations

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HealthyPreschoolers
HEALTHY Social and Emotional Development in
Preschoolers is Evidenced by

• Self-direction in learning situations
• Ability to tolerate frustration
• Desire to resolve peer conflicts

• Motivation to succeed linked to feeling
  competent and loved
• Empathy
• Cooperation
• Persistence

National Research Council, 2000
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Threats to Childrens Mental Health

• Trauma
• Exposure to Domestic Violence
• Abuse
• Neglect
• Lack of stimulation
• Stress, even prenatal
• Inability of caregivers to cope
• Family mental health or substance abuse issues
• Poverty

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Social Emotional Concerns Behaviors

• Excessive hitting or biting
• Over-activity
• Under-activity
• Extreme fearfulness
• Withdrawal

• Avoidance of social interaction
• Inconsolable crying
• Excessive tantrums
• Self-harming behaviors
• Inability to connect with caregivers
• Culter Gilkerson, 2001 Unmet Needs Project,
  2001

16 of children ages birth to three indicate a
prevalence of social emotional concerns.
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Hand in Hand is
Emotional support for families Peer support
from other parents Help with the childs
behavior
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What would a Hand in Hand child look like?

• Child pushes parents and caregivers to the edge
  family unable to cope with childs behaviors
  at home
• Child is dismissed from childcare due to
  unacceptable
• behaviors
• Child has witnessed domestic violence
• Child cannot interact with other children
  other parents keep their children away
• Child may have been exposed to substances or
  alcohol prenatally or in the home

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What would a Hand In Hand family look like?

• Family members are unable to lead normal social
  lives out of fear of childs disruptive
  behavior
• Family members may have substance abuse issues
  and/or mental health problems
• Family has a history of ongoing traumatic events
  such as child abuse or neglect domestic
  violence hospitalization long-term illness
  death and grieving periods of homelessness
  poverty or unemployment

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What would a Hand In Hand family look like?

• Family has had to move and transition frequently
  due to CPS involvement, divorce or
  incarceration
• Parents fall asleep at night worrying about how
  to deal with their childs needs tomorrow

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Eligibility

• Federal Standards
• Diagnosis of Serious Emotional Disturbance
  using the DSM IV-TR or
• For Infants, birth through age 3 years DC 0-3R
• Birth through six years of age
• Resident of one of 5 counties (except the City
  of Fort Worth)

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Referrals

• Outreach
• Hand in Hand accepts family referrals during
  outreach presentations
• Agency Referrals
• Provider can contact Hand in Hand with the
  parents consent
• Release of Information form required
• Future plans referrals through CSMIS
• Self Referral
• Parent can contact Hand in Hand directly.

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For Services Contact Stephanie Norton Clinical
Director 817-569-5729 Stephanie.Norton_at_mhmrtc.org
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Services

• Family driven
• Provided by a team of trained staff and family
  partners
• Providing strengths-based care coordination
• Working with existing service providers and
  collaborating with new partners
• Providing intensive home-based services
• Utilizing a System of Care philosophy work
  with the family to identify formal and natural
  supports

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Early Childhood Mental Health Partners
FAMILY PARTNERS

• Family Support Led by Lead Family Contact
• and Family Connection
• Developing advocacy skills
• Guiding families through medical, school and
  social
• services systems
• Mentoring
• Assisting with referrals to community programs
  and
• services
• Providing a listening ear and empathy have
  walked in similar shoes
• Assisting with care coordination

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Early Childhood Mental Health Partners

• COMMUNITY PARTNERS
• Intervention provided by Program Director,
  Clinical Director and Care Facilitators

• Infant/Child Assessment DC 0-3R, DSM-IV-TR
• Team and Family Plan development
• Parent-Child Interaction Training (PCIT)
  coaching parents on dealing with childs behavior
• Promotion of other evidenced based practices
  for 0-6, e.g., TF-CBT

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Early Childhood Mental Health Partners
COMMUNITY PARTNERS Intervention provided by
Program Director,Clinical Director and Care
Facilitators

• Support, encouragement, positive reinforcement
  for child and family
• Family stabilization
• Care coordination and referral for services,
  including the provision of Flex Funds

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Hand in Hand hopes to improve the outcomes for
all children by improving the social-emotional
context in which they grow.
I have long been a strong believer in preventive
care to identify all potential health concerns
early. The services provided by the Hand In Hand
program will be a great benefit to families,
young children and our community as we continue
implementing a system of care approach to address
mental health issues. Kay Granger,
Congresswoman
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Hand in Hand hopes to improve the outcomes for
all children by improving the social-emotional
context in which they grow.
Nobody likes change, except a wet
baby. ---Sarah Swinney, Family Advocate with
the Bipolar Depression Alliance
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Training

• Review evidence-based practices
• Partner with existing initiatives in the
  community, such as Mental Health Connection
  Implementation Teams, Early Childhood
  Intervention and Early Connections for
  Childrens Mental Health
• Train all staff in Parent Child Intervention
  Training (PCIT) and cultural competency to
  meet the comprehensive needs of children
  and families

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Training

• Develop a Hand in Hand Training Curriculum
• Involve family members in developing curriculum
  and assisting with the teaching
• Utilize a family-driven, strengths-based
  approach
• Develop community expertise in using DC 0-3R
• Develop a speakers bureau to promote the
  system-of-care model

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Program Evaluation

• Data to be collected will include
• Child and Family Level
• Demographics and descriptive information
• Presenting problems and diagnosis
• Risk and protective factors for the child and
  family
• Functioning and problem behaviors for child and
  family and how they change over time
• Family empowerment and data collected
  qualitatively in personal stories, as well
  as quantitatively

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Program Evaluation

• Data to be collected will include
• Program and System Level
• Number of services received by type
• Service system strengths, gaps and access
  barriers
• Efficacy of training efforts
• Cost of service provision
• Systems change on community and family levels

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Employment Opportunities

• Cultural Competence Coordinator
• Youth Coordinator
• Wraparound facilitators and agency-based
  supervisors by Request for Proposal (RFP)

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Get Involved with Hand in Hand

• Refer families for services
• Get involved with the development of the program
  as part of Hand in Hand local coordinating
  groups or family support groups
• Participate in upcoming trainings
• Become a voice for our youngest children
• Become a community speaker for Hand in Hand

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Hand in Hand Team Jan Finch, LCSW, Ph.D.,
Program Director 817-569-5722 Kris Painter, LCSW,
Ph.D., Lead Evaluator 817-569-4443 Grace White,
Director of Nursing 817-569-4354 Stephanie
Norton, LMSW, Clinical Director 817-569-5729 Jamie
Souders, Lead Family Contact 817-569-5728 Kim
Fisher, Administrative Assistant
817-569-5721 Sean Allen, Ph.D., Technology
Coordinator 817-569-4434 Camille Patterson,
Ph.D., Sr. Evaluation Spec. 817-569-4486 Barbara
Perry, Family Evaluation Spec.
817-569-5723 Kathryn Brown, Bilingual Evaluation
Spec. 817-569-5724
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For general information 3880 Hulen Street,
South Tower, Suite 610, Fort Worth, TX
76107 Hand in Hand Main Office
Number 817-569-5720 www.mentalhealthconnection.or
g   www.familieshandinhand.org (currently under
Construction)
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Adapted from Building Blocks Program in
Connecticut.

• We acknowledge help from Building Blocks, another
  SAMHSA SOC grantee, in the development of this
  PowerPoint.

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• Funding and Technical assistance for this
  program is provided by the Substance Abuse and
  Mental Health Services Administration (SAMHSA) of
  the U.S. Department of Health and Human Services
  and community partners.

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• Hand In Hand
• Questions and Answers

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Children can heal in the context of supportive
relationships.