Youth with severe behavioral health concerns often need legal support to navigate the many systems that affect their access to appropriate care. Health Law Advocates (HLA) is a community-based legal services organization in Massachusetts that provides free legal representation to low-income eligible families. The Mental Health Advocacy Program (MHAP) for Kids is HLA’s largest program.
The challenge: Barriers to behavioral health care
According to MHAP for Kids, 97% of families surveyed reported experiencing at least one barrier to accessing mental health services. These barriers can include:
- Time and cost associated with mental and behavioral health care.
- Bureaucratic delays in obtaining access to the correct services and support.
- Incomplete or inaccurate information regarding treatment and support services.
- Fear, dislike or distrust of professionals in mental health care or social services.
Many behavioral health care systems and services have been overwhelmed by a rise in patients seeking mental health treatment, making it even more difficult for families to access the help they need. “We're in the midst of one of the worst public health and mental health crises,” says Marisol Garcia, senior director of HLA. “We're really seeing that demand.”
Finding solutions: Advocating for kids and families
Working from family resource centers across the state, MHAP for Kids advocates for families by:
- Helping them gain access to health insurance.
- Representing parents, guardians, and students in special education and school discipline matters.
- Seeking eligibility and services from state agencies.
- Advocating for general education accommodations.
“Our mission is to improve the health and increase the educational success of kids by diverting kids from juvenile justice and child welfare and ensuring kids can access the mental health services that they're entitled to,” says Garcia.
Collaborating for change
Boston Children’s Hospital Accountable Care Organization (ACO) covers Medicaid patients within the hospital’s network and encompasses over 130,000 youth across the Commonwealth of Massachusetts. Boston Children’s ACO partnered with MHAP for Kids to educate staff and enable patients and families to better navigate these challenging systems and improve the health and educational success of children with unmet mental health needs.
As part of this partnership, MHAP for Kids provided training materials and training sessions to educate primary care providers, integrated behavioral health clinicians and other medical home care coordination staff on topics such as supporting students in school, the juvenile court system and how state agencies can further support families.
MHAP for Kids also provided consultations with a senior attorney, allowing providers, clinicians and support staff to ask questions and receive guidance on best practices. This relationship also allowed providers to directly refer families and patients to appropriate services and ensure they had access to the program when needed.
MHAP for Kids also collaborated with the Boston University School of Public Health to study the impact of these services on the pediatric population and worked together with Boston Children’s ACO to evaluate this data and develop a sustainable model to expand the program.
The results: Improving health
Katherine Engel, senior project manager for Boston Children’s ACO, says the program has “moved the needle” in an area that is traditionally difficult to influence. “MHAP services really target youth at the top of the behavioral health pyramid. They have the highest level of need, and we know that these are the children that providers worry the most about. They also incur the greatest costs,” says Engel.
An independent study of the program found that in addition to improving children and parents’ mental health, MHAP for Kids has improved school attendance and decreased hospitalizations and the use of emergency mental health services.
Together, MHAP for Kids and Boston Children’s ACO are continuing to work to expand statewide capacity and increase funding for the program. Through their partnership with Boston University School of Public Health, the organizations are also continuing to collect, analyze and publish data on the effect these services have for children and their families.