A Groundbreaking Rural Mental Health Initiative for Youth

By Sandra Bellassai, MPH, Herkimer System of Care Project Director

In August of 2019, Herkimer County, through our Department of Public Health, was awarded a four-year grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to implement a System of Care approach to “support the provision of mental health and related recovery support systems to children and youth with serious emotional disturbance (SED) and those with signs and symptoms of serious mental illness.” Herkimer County is made up of mainly rural communities, has only one established city and is a federally-designated mental health provider shortage area.

The three main goals of this project are to improve the mental and behavioral health of children attending school, improve the emotional and psychological strength of families, and reduce the number of youth involved in the juvenile justice system. In tackling these goals, we are adopting a gradual-layered approach of service delivery and expansion.

In years one and two, we partnered with United Way of the Mohawk Valley to embed Family School Navigators (FSNs) into five of the main school districts across the county. The FSNs acted as liaisons between the families, schools, and the SOC project. Through working one-on-one with students and their families, FSNs were able to screen children and youth for early signs of SED and make referrals to mental health and support services as early as possible. Once the FSN team joined our initiative and the number of youth served started to increase, we realized that the need for a centralized referral and intake system was necessary. In year two, we brought on the SOC Child and Family Team through a partnership with Integrated Community Alternatives Network (ICAN), composed of a Support Coordinator, a Referral Supervisor, and a master’s level Mental Health Counselor. These individuals work in tandem with the community to receive referrals, connect with families, conduct assessments, and link them to mental health and support services as quickly as possible. To address transportation barriers in our county, the Child and Family team carries out services wherever it is most convenient for the family.

Once we had our centralized intake and referral system operational, we continued our efforts to increase mental health provider capacity and access by contracting with ICAN for “a la carte'' support services. Some of these include behavior management, mentoring, family peer support. During this time, we also began a new partnership with The Neighborhood Center to support their efforts in establishing a mental health clinic right in the heart of Herkimer, New York that would offer counseling and psychiatry services to local youth. The Neighborhood Center quickly became a heavily utilized resource in the county for outpatient mental health clinical services. By the end of year two, we were able to connect referred families to mental health providers within our developed System of Care network within 1-4 weeks from intake date.

To date, we have connected and linked more than 250 youth and families to mental health services and supports within our local community.

In year three of implementation, we continue to offer all of the same mental health services, but have expanded our initiative to incorporate youth engagement efforts, and SEL learning and development for children in daycares.

To be more specific, we have partnered with Catholic Charities of Herkimer County to increase school-aged youth engagement in our System of Care efforts. Through this collaboration, we are incorporating a Youth Advisory Council, developing an inter-county volunteer mentoring program, and creating more opportunities for our youth to develop leadership skills.

Our work in engaging youth begins within the youngest population of Herkimer County, the children who attend daycare. Cornell Cooperative Extension of Oneida County’s (CCE) Mid York Child Care Council program is working alongside our initiative to ensure that daycare providers have evidence-based social-emotional learning curriculum to implement in their daily routines. Our SEL educator with CCE provides direct outreach and support to daycare providers by implementing curricula within their programs to demonstrate how engaging, easy, and effective the lessons are. We have received positive feedback from providers and to CCE’s services. With support from CCE, various daycare programs are beginning to implement universal SED screening using the ASQ-SE for the children in their facilities. As a result, we have been able to support the children scoring “high” with services offered through the system of care that we have developed.

To date, we have connected and linked more than 250 youth and families to mental health services and supports within our local community. We attribute this success in breaking down barriers to accessing quality services to the funding we have received from SAMHSA, in addition to the commitment and dedication of the organizations across our county.