Cross-System Collaboration to Support Children and Youth With Behavioral Health Needs and Their Families
This SAMHSA policy paper examines how children and youth with behavioral health needs often interact with multiple public systems, including child welfare, juvenile justice, education, developmental disability services, housing, Medicaid, and behavioral health agencies. It argues that fragmented systems can create barriers to timely, effective care and increase the likelihood of poor outcomes, restrictive placements, and multisystem involvement.
It explains how each system intersects with behavioral health and why coordinated approaches are needed to support children and families effectively.
Recommended Strategies
The report encourages Medicaid, behavioral health, and public health leaders to:
- Learn how child- and family-serving systems are structured in their state and build relationships with system leaders.
- Use a systems of care approach that includes families, youth, community organizations, and multiple agencies working together.
- Leverage Medicaid authorities and funding mechanisms to expand home- and community-based behavioral health services.
- Partner with Certified Community Behavioral Health Centers (CCBHCs) and other providers to improve care access.
- Implement “no wrong door” access models so families can obtain services regardless of where they first seek help.
- Strengthen cross-agency governance structures and use data collaboratively for planning, quality improvement, and accountability.
Relevance for Child Welfare and Adoption Competency Work
For organizations working at the intersection of behavioral health and child welfare, the paper reinforces that children involved in foster care, adoption, kinship care, and other public systems often have complex behavioral health needs that cannot be addressed by a single agency. It highlights the importance of cross-system partnerships, family-centered services, coordinated financing, and community-based supports to prevent unnecessary out-of-home placements and improve long-term well-being.