Harris County Children, Youth, and Families Systems Assessment

Thanks to the generous support of Houston Endowment, the Meadows Institute conducted a comprehensive assessment of health care system capacity for providing mental health services for Harris County children, youth, and families.

The study found that, as in most places, mental health care in Harris County is delivered – when it is delivered – at the specialty care level. The Meadows Institute noted a lack of help being provided on the primary care or rehabilitative levels.

Effectively, this created a systemic barrier to care that caused many families to not seek care at all, at least until symptoms reach a crisis level, and that, all too often, occurs in a juvenile justice facility or an emergency room,

The study also examined social determinants of health, including economic stability, education, health, access to health care, and the social and community context in which children and youth live. Further, it studied pockets of need across the county, far from treatment providers and public transportation, and many outlying school districts lack providers within their geographic borders.

The study recommended a transformation from a disjointed, fragmented system into a coordinated, “Ideal System of Care,” which includes:

• Integrating behavioral health into pediatric primary care settings, where most mild-to- moderate needs – such as anxiety and depression – can be ably treated.
• Providing specialty behavioral health care for children and youth with more complex, moderate-to-severe needs.
• Increasing the availability of rehabilitation services for children and youth with the most severe needs.
• Creating a Crisis Care Continuum able to respond to a full range of periodic, intense needs that routinely occur during treatment, including mobile teams able to respond to the most urgent needs.

This report detailed the strengths and weaknesses of the Harris County system, and outlined a path toward making it more effective and responsible for all of the county’s young people.