In Summit County, more than 12,000 children and adolescents have some diagnosable mental illness. The stigma associated with mental illness, however, is often a barrier to treatment, as is the lack of access to services and available providers.
Child Guidance & Family Solutions is a nonprofit established to address the problem. The organization specializes in child and adolescent mental, behavioral and emotional health. It employs child psychiatrists, psychologists, nurse specialists and counselors to assess, diagnose and treat children adolescents with these health concerns while supporting and assisting the families through the treatment process.
While its mission is clear, how it maintains the resources necessary to carry it out is not as certain.
“We are challenged by demand for some very specialized services, such as home-based services and psychiatric services due to the limited workforce,” says Elaine M. Harlin, president and CEO of Child Guidance & Family Solutions. “There are more licensed counselors and social workers retiring than there are new professionals entering the field. There are only 7,000 certified child psychiatrists in all of the U.S. However, to adequately address the need for child psychiatrists, the U.S. would need 30,000.”
Smart Business spoke with Harlin about how the organization is coping with these challenges.
SB: How do children and families end up coming through the doors of your organization?
EH: Our top referral source is previous clients/parents. They tell a neighbor or other family member who may be concerned for a family member but not sure where to get help. We also receive referrals from schools, doctors’ offices, child welfare organizations and courts.
SB: How has Child Guidance & Family Solutions’ service model changed in recent years?
EH: For 75 years we have been helping families and their children in a variety of different models. We have developed from a ‘social service’ model of providing basic needs — assistance with housing, jobs, clothing, etc. — and treatment to a ‘medical model’ focusing on the assessment, diagnosis and treatment related to the mental, behavioral or emotional concern.
We believe there is no health without mental health. Collaboration between Kaiser Permanente and the Centers for Disease Control and Prevention produced a study of Adverse Childhood Experiences (ACE). The ACE Study findings suggest that certain childhood experiences are major risk factors for the leading causes of illness and death as well as poor quality of life in the U.S. The higher the number of ACE incidents a child experienced, the higher the risk for serious physical health disorders, such as chronic obstructive pulmonary disease, heart disease, liver disease, depression, alcoholism, etc.
A survey of pediatricians throughout Ohio indicated their top three concerns with children/youth are: obesity, early diabetes and mental health issues.
We are now taking a ‘whole-ness’ approach to how we work with families and their children. If parents haven’t had their child to a doctor, we talk with them about physical health concerns of their children. We connect them to doctors for treatment of those concerns. The interrelationship between mental wellness and physical wellness is important to the ‘whole-ness’ of that child/adolescent.
SB: What challenges does your organization face in terms of staffing?
EH: The most significant challenge is workforce retention, development and recruitment. We provide excellent training in best practices in mental health care. Despite this investment, young professionals are pulled in many directions in their early careers that may take them out of state or to other fields of work. It is also more and more challenging to offer attractive salaries.
SB: How is your organization coping with the staffing challenges it faces now and heading into the future?
EH: We continue to develop more volunteer opportunities and internships for future recruitment prospects. However, we must balance this with our ability to provide necessary professional supervision without diminishing the capacity to serve clients who need our help.
We continue to develop and integrate our mental health professionals with other medical practitioners.
SB: How do you mitigate burnout to help retain employees?
EH: In our annual employee surveys, our employees consistently cite their professional development, learning clinical best practices and the support of their supervisors as their top valued workplace characteristics. Longevity of our employees averages more than 15 years, so we must be doing something right.
We appreciate the stressful circumstances in which our staff is frequently placed. We support them through team building and peer supports and in very difficult circumstances we also offer assistance through external resources.
We listen to staff feedback of issues. Some things result in process changes to ease pressure, some things are not as easy to fix, such as growing caseloads. However, we continue to listen and support in ways that we can.
SB: What worries you most as head of Child Guidance & Family Solutions?
EH: I like to be proactive in developing a solid future for Child Guidance & Family Solutions. It takes vision, planning and resources to do so. Health care is changing so rapidly and in so many different ways — technology, consolidations/mergers, financing. I worry that the developments we create today may not be sustainable, but greatly needed. So, creating ways for Child Guidance & Family Solutions to remain viable and strong for another 75 years is always on my mind.
