The Children’s Mental Health Campaign (CMHC) grew out of an initial collaboration between Children’s Hospital Boston and the Massachusetts Society for the Prevention of Cruelty to Children (MSPCC). In 2006, they published a study entitled “Children’s Mental Health In The Commonwealth: The Time Is NOW” which examined the system of care for children with mental health needs in Massachusetts. Not surprisingly, the report demonstrated that there were significant shortcomings in the children’s mental health system.
MSPCC and Children’s Hospital Boston joined together with the Parent/Professional Advocacy League (PPAL), Health Law Advocates, and Health Care For All (HCFA) to form the CMHC in 2007.
From these five members of the executive committee, the CMHC has grown over the years to include a diverse coalition of over 160 endorsing organizations, families, advocates, health care providers, and educators who are dedicated to ensuring that every child in the Commonwealth receives the highest quality mental health care. In 2018, the Massachusetts Association for Mental Health (MAMH) joined the Campaign's executive committee.
In its independent review of the Campaign, Community Catalyst credited the Campaign "with raising the visibility of children’s mental health as a critical issue both within [state government] ... and among the public. The Campaign partners are viewed as highly credible advocates who are able to operate within the policymaking process at a very sophisticated level.... The Campaign leadership and coalition members represent the best thinking of the provider, family, and advocacy community around mental health... and it’s viewed as a formidable force.”
The Campaign has converted its credibility and influence into several major policy accomplishments which have redefined the landscape of children's mental health system. In 2008, the Campaign was instrumental in securing passage of two landmark laws. An Act Relative to Children's Mental Health (Chapter 321) creates a structure for enhancing early identification, treating children in the most appropriate setting, enhancing coordination among state health care agencies and establishing mechanisms for oversight of and input into the state children's mental health system. Chapter 256 strengthened the state's mental health parity law by expanding the categories of disorders for which health insurance plans must provide mental health benefits.
In 2011, the Campaign scored another major legislative victory when it led the drive to replace the state's failing CHINS (Child in Need of Services) system with for coping with children with serious disciplinary issues (many of whom suffer from mental health problems) with a new FACES (Families and Children Engaged in Services) system which offers families access to community-based mental health treatment, special educational assistance and other services to keep children out of the juvenile justice system.
One of the factors in the Campaign's success has been its determination to hold key stakeholders accountable for implementing the new laws secured through its advocacy efforts. This work seldom garners headlines but is vital to ensuring compliance and effective regulation. The Campaign has earned a permanent seat at the table in mental health policy deliberations, and is willing to raise issues and concerns with policy makers and other stakeholders and even leverage its strong media relations to bring outside pressure to bear in effecting change. The Campaign also has succeeded in securing the necessary funding for preserving critical state services and the Children's Behavioral Health Initiative. While remaining focused on effective implementation, the Campaign has preserved the flexibility to respond to emerging issues (such as its strong resistance to major cuts in inpatient pediatric mental health beds).
The work of the Campaign is beginning to result in important changes at the system-level (e.g., reducing by half the number of "stuck kids" in inappropriate inpatient units), state level (e.g., improved interagency communication and institutionalization of the Children's Behavioral Health Advisory Council), provider level (e.g., improving early screening of mental health problems) and in the community (e.g., assessing capacity of schools for identifying and responding to mental health problems).
Despite its record of success over the years, the challenge of creating an effective children's mental health care system remain daunting. There are many issues in which the Campaign is engaged, but three areas reflect its current priorities:
With major changes taking place in way health care is being delivered and reimbursed, the Campaign has been at the forefront in working with the state to ensure that mental health considerations are reflected and integrated into new payment and care delivery models
Schools are vital to the success of any efforts to improve early identification and to expand access to mental health care services. The Campaign is focused on several initiatives to improve the capacity of schools for dealing with mental health issues and to establish model behavioral health system and policies for schools (e.g., reforming grade retention and student progression policies)
Policy evaluation is greatly hampered by the lack of data for measuring the effectiveness of the children's mental health care system along critical dimensions (e.g., access to specialized care). The Campaign is making a concerted effort to develop and secure the adoption of outcome measures which can be applied to all payers and can constitute a "dashboard" for measuring system effectiveness across several dimensions.