SHERIDAN — For some families, simply signing a child up for soccer or grocery shopping with a toddler in tow can be intimidating, Compass Center for Families Executive Director Susan Carr said.
High Fidelity Wraparound programs and organizations like Compass help families facing mental health challenges at home practice these types of activities and support lasting family strength, she said.
Wyoming’s High Fidelity Wraparound program is living up to its goal of connecting youth to resources that fulfill mental health needs in their homes and communities rather than psychiatric treatment facilities, according to Magellan Health.
Linda Vallejo connected to the HFW program through Grandparents Raising Grandchildren at The Hub on Smith.
Vallejo has guardianship and is raising two of her great-grandchildren.
Compass staff visit with her great-grandson once a week to help work through some of his behavioral problems.
“[The children] only treat me mean because I’m the one that doesn’t run away,” Vallejo said. “[Compass staff] come in and they try to talk to the kids and talk to the family and try to figure what they can do to help the children and me.”
The one to two hours Compass staff spend with the children allow Vallejo some time to relax. While she was ahead of the curve connecting to mental health resources on her own before becoming involved with HFW, Vallejo said the program is currently helping with home improvements to make her house more compatible for her great-grandson. Both childrens’ behavior has also improved.
“All around, everything helps me,” Vallejo said.
Apart from the benefit to families and communities, there is a substantial cost savings to involvement in HFW programs, Carr said.
In 2018, the cost per year per youth who received care in an inpatient psychiatric facility was $58,027. The Medicaid cost associated with a HFW program graduate was $14,898 per year per youth. Readmission to inpatient psychiatric care decreased by 33% over a three-year period, according to the Wyoming Department of Health.
Magellan Health operates the HFW program in collaboration with the Division of Health Care Financing in the WYDOH. The program aims to support youth facing behavioral and mental health challenges, providing individualized alternatives to traditional treatment methods, according to Magellan.
“When youth behavior is extreme, there is higher probability of needing to leave home or school to address their needs in a clinical, therapeutic or detention setting. We meet people where they are…to identify needs and strengths, which inform the team of behaviors that should be addressed,” Tammy Cooley, senior director of operations, said in a press release.
The severity of specified mental health issues decreased for more than 75% of youth enrolled in the HFW program, according to Magellan.
Family care coordination, adult and youth peer support and other services are intended to maintain family and community connections and develop life skills to become successful and healthy in adulthood, according to WYDOH.
Natural community supports can be more effective for families facing mental health challenges than associations with professionals at the Department of Family Services or law enforcement, Carr said.
“That can be so much more empowering and rewarding when you have a family that says, ‘This is what I want my family to look like. Not what DFS thinks my family should look like, or the court,’” Carr said.
A 2019 assessment showed all key intervention areas through HFW decreased from a child’s initial assessment to graduation from the program. Some of the most prominent decreases included about a 23% decrease in oppositional behavior and about a 32% decrease in anger control issues.
Social functioning problems decreased by half and non-suicidal self-injurious behavior decreased from 19.5% to 3.6%.
Wyoming Medicaid contracted with Magellan in 2015 as a care management entity that works with WYDOH, Wyoming Department of Family Services and other providers and contractors to form support teams.
The teams aim to improve mental health care for enrolled youth ages 4-20 and lower the cost of treatment by keeping Medicaid-enrolled children who qualify for inpatient care at home rather than out-of-home placements, according to WYDOH. The program has worked with 943 Wyoming youth as of February 2019.
Families experiencing mental health or trauma-related challenges at home often lack the supports upon which other families rely, Carr said. HFW helps identify and develop those supports.
“Those [community supports] are all protective factors that are in place to help families stay strong,” Carr said. “But when you’re a family that is struggling because of poverty issues or isolation or whatever issue it is, those can be really intimidating places so they don’t use them. They don’t access those sources of strength that are in the community to help them thrive.”
Vallejo encourages parents and grandparents facing behavioral challenges with children to reach out and access the resources available in their community. Behavioral and mental health problems with children can take their toll on parents and guardians, she said.
“It’s nice to know that there’s somebody out there that will help and listen to the adult side of it,” Vallejo said.
Many children are resistant to listening to adults because they have been raised in difficult situations with adults who have caused disruption or inconsistency in their lives, she said.
Looking ahead, Cooley said Magellan Health plans to continue growing their network of HFW providers and reach as many eligible youth as possible.