Roadblocks and Stopgaps: A Review of Factors Obstructing the Development of Comprehensive Child Mental Health Services

Abstract

Even under conditions which might be considered ideal for the development of a comprehensive system of services for disturbed children and adolescents (adequate financial resources, good recruitment and training programs and collaboration between different government departments concerned with youth), there are factors which mitigate against the development of a logical service system. Program development is groomed by its historical background, coloured by prevailing societal attitudes toward children and skewed by the existing funding mechanisms. The case records of children and adolescents referred for assistance in residential treatment placement over a five-year period are analysed in terms of previous interventions. It is evident that the multifaceted nature of the family, social, treatment, and educational needs of children are tackled piecemeal; each agency bringing its resources to bear only on one aspect of the child's functioning and extruding the child when its repertoire of child altering behaviour is exhausted or deemed ineffective; at this point referral is made to another agency or system, resulting in a discontinuous, frequently ineffectual series of “helping” efforts. Understanding, modifying and coordinating service development will require interactive planning between all the caring, treatment, and educational systems on behalf of the child population.