Although childhood is typically perceived as a time of carefree happiness, children and adolescents can also face many challenges to their mental health.
For starters, many youth contend with difficult home issues like poverty, lack of food, poor family harmony, and even domestic violence. On top of these difficulties, about one in six children in the U.S. must also cope with a developmental disability such as ADHD, autism spectrum disorder, cerebral palsy, or other intellectual and learning disabilities. Finally, about half of all mental disorders start before or during the teenage years, further complicating life for youth who have them.
When a youth’s behavioral health needs are relatively mild or moderate, interventions such as individual therapy or counseling, family therapy, or skills training can be sufficient to help them address whatever challenges they may face. However, sometimes a child or teen needs a greater level of support to account for severe or very complicated behavioral health difficulties. In these cases, “wraparound” services may be the best option.
To learn more about wraparound services and how they fit into a behavioral health continuum of care, we spoke with Lakisha Wren, Wraparound Team Lead for our Hendricks County office. In this blog post, Lakisha explains what wraparound services entail, who might be a good fit to receive them, and how they can help create stability and healing for youth with greater behavioral health needs.
Comprehensive Support for Complex Challenges
Wraparound services (also referred to as “wrap services” or “the wraparound process”) are intensive care programs specialized for the specific needs of each consumer. They comprise the highest level of care provided by community mental health agencies, and they are the last option before a youth is removed from their home for treatment purposes. “We work with youth who are at risk of being placed into residential facilities or acute hospitalization,” Lakisha explains.
In Indiana, wraparound services are funded by the Department of Child Services (DCS) and the FSSA’s Division of Mental Health and Addiction (DMHA), and children between the ages of 6 and 18 are eligible. Because the entire family tends to be involved in situations of this kind, wraparound services may be extended to everyone in the household. “We wrap services around everyone, not just the focus child. The mom, the dad, siblings—everyone can get services under the grant,” Lakisha says.
As the access site for wraparound services in Hendricks County, Lakisha is the first person a family will speak to if they are referred for wrap services. Lakisha’s job is to assess their eligibility and connect them with the appropriate care providers. “I’ll assign a therapist and a life skills specialist, and if they need more intensive services, that’s when I would assign a wrap facilitator,” Lakisha explains. “Then they might also receive habilitation services, respite services, and family support training as well.”
Regardless of the exact services provided, the wraparound process is always guided by four key principles of care:
- Grounded in an inner strengths perspective: service providers assume that every individual possesses valuable inner strengths that can help them thrive in life if they are developed and applied
- Family voice and choice: all family members have a say in their care and can choose how they would like services to proceed
- Strengths-based: service providers aspire to identify each individual’s constructive life skills and nurture their development—not fixate on personal shortcomings
- Outcomes-based: all services are designed to work toward a positive end result as defined by family members and care providers
How Wraparound Services Create Outcomes for Youth and Families
The overall goal of wraparound services is to address whatever challenges a youth is facing without removing them from their normal home environment. With this in mind, efforts are also made to make services as unobtrusive as possible to a child or teen’s daily life. “A lot of our youth do not work well just with traditional services,” Lakisha explains. “They don’t do well just sitting, discussing their feelings and trying to stay focused for a 45-minute session. So, we try to be very creative and think outside the box with our plan of care.”
This is precisely where non-clinical service providers and interventions shine. “If skills training isn’t working, we might try some fun habitation services,” Lakisha says. “For example, a mentor could meet with the youth out in the community and try to do skills training at a basketball court, or just while walking around the community. I think that’s why a lot of our families benefit from wrap services—we try to be creative and make it fun for them.”
According to Lakisha, the highly individualized nature of wraparound services are another important key to their effectiveness for youth and families:
“You may have Johnny who does not do well in a school setting, but we can have a support person at school who can sit next to him, help knock down some of those barriers and underlying needs, and pull the teacher aside and say, ‘Have you tried to do this with him, have you tried to do that?’ We can have a habitation provider help that teacher work with Johnny—explain Johnny’s needs, his care plan, and how the teacher can be creative with Johnny. Or we could have another individual who is struggling with just getting up, going to school and being motivated each day, or has suicidal ideation. We can give that person a mentor who’s there on the weekend to pick them up and take them to peer mentoring groups out in the community, or just sit down with the parents and talk about why it’s important to have crisis plans, help them understand suicidal ideation, and things like that. It’s just about having an individualized plan of care for every youth and family.”
By surrounding a youth with various types and levels of support, wraparound services can effectively treat complex behavioral health issues during childhood and adolescence. Most importantly, their focus on helping the whole family lowers the chances that problems will resurface in the future—and keeps youth in the home and community environments where they are loved and feel most comfortable.
Looking for more information about the types of services provided at Cummins Behavioral Health? You might enjoy our blog posts on employment services and substance use disorder services below!