Friday, April 1, 2022
On the record with Dana Weiner, director of the Children’s Behavioral Health Transformation Initiative
Gov. JB Pritzker recently chose Dana Weiner to lead a new initiative to improve behavioral health services for children. Weiner, a senior policy fellow at Chapin Hall at the University of Chicago, will work alongside six state agencies to build a coordinated, interagency approach to ensure access to care and further transparency for parents and caregivers in the process. “Our goals are to make behavioral healthcare more accessible to children and to make the process of accessing behavioral healthcare more transparent to families,” Weiner told Health News Illinois this week. She also spoke on the issues facing behavioral health and the need for collaboration to ease access to care for children and their families. Edited excerpts below.
HNI: How did you become involved with the initiative?
DW: I am a senior policy fellow at Chapin Hall at the University of Chicago, a clinical psychologist by training and a researcher in practice. For the last 22 years, I have been providing program evaluation, technical assistance and data analytic consultation to child welfare, juvenile justice and other human service systems in Illinois and across the country. So I have a background in mental health treatment, as well as in advising public systems with data-driven decision making and empirically-based solutions. The governor asked me to lead this initiative due to my deep familiarity with our human service systems and the challenges they face. So I think that’s probably the big picture answer. The work that I’ve been doing in other places like California and Michigan has also been focused specifically on some of the residential intervention resources that child welfare systems have available to them.
HNI: What are some of the initiative’s priorities?
DW: Our goals are to make behavioral healthcare more accessible to children and to make the process of accessing behavioral healthcare more transparent to families. What we proposed to do to reach those goals were three broad sets of activities. One is coordination among the six child-serving agencies that have come to the table to both provide short-term kind of crisis staffing solutions for cases that are waiting for care, but also to think through some of the broader systemic issues. So providing coordination across the leaders and representatives from those agencies is the first part. The second part is the analytic work that we need to do to ensure that we have the appropriate resources for children who need behavioral healthcare and that the pathways to accessing care are clear and consistent. And so those analyses include a number of different, more empirical activities like the geospatial gap analysis to suggest capacity adjustments, like business process mapping to understand the pathways by which families access resources, a policy analysis to identify potential misalignment between policies, and that includes some of the complex rate setting issues that I think are also part of the problem. And then the third area is planning. So that is the development of a blueprint for system transformation. So those are really the three kind of broad areas of work that we propose to do in order to reduce some of the problems that we’re seeing, long waits for care and complicated difficult-to-access resources.
HNI: What are some of the current challenges?
DW: So I think that the big challenges we’re trying to address have to do with capacity. How do we right-size the continuum of resources to address behavioral healthcare needs for children? And that includes community-based services and supportive home-based interventions, as well as residential interventions. As a researcher, I’m treating all the explanations as hypotheses until I actually test them with data. But there certainly are a lot of hypotheses having to do with workforce shortages and rate differences among agencies. There are a number of things that might be driving those capacity issues that we’re going to try to address. That’s one thing. The second set of problems I think is that we have fragmented and circuitous pathways to actually get to resources. The agencies (Department of Children and Family Services, Department of Healthcare and Family Services, Department of Human Services’ Division of Mental Health and Division of Developmental Disabilities, Department of Juvenile Justice, Department of Public Health and the Illinois State Board of Education) all exist to meet the needs of children and families, but sometimes involvement with one of those agencies precludes involvement with another. So what we’re trying to do at the outset of this is get a really good, clear map of all the different on-ramps and entry points and touchpoints that these agencies have so that we can then kind of examine what we think the ideal pathway should be. If the first set of problems has to do with resources, the second set of problems has to do with pathways to accessing those resources that haven’t historically been consistent or transparent to families.
HNI: Now that the initiative’s been announced, what are the immediate next steps?
DW: Over the last couple of weeks, I’ve already been meeting with lots of stakeholders. I’m obviously not the first person to examine this issue, and it’s the strength of ours in Illinois that we have many, many groups that are focused on understanding what children and families need and making recommendations. So I’ve been meeting with a lot of those stakeholders in addition to meeting with the leaders of the six agencies. I lead the weekly interagency crisis staffing call that has been underway, so there’s the coordination piece has already begun. The analytic work is beginning with the business process maps. So we’ve already begun to draft kind of an overall map and then some specific agency-level maps about how people access specific programs. And then we’re working on assembling the data that we need to do the gap analysis to understand what adjustments we need to capacity.
HNI: What are we seeing right now as it relates to mental health in young people?
DW: Research is suggesting that the rates of mental health problems among young people are higher, particularly during and as we come out of the COVID-19 pandemic. So I do think we’re at a challenging juncture where we have an increase in need and potential workforce shortages and other issues that are making it difficult to access care. So the governor’s investments in examining this issue and addressing some of the capacity shortfalls are really coming at an opportune moment.
HNI: What more can policymakers do to support initiatives like this?
DW: I think one of the most important things is the interagency collaboration that will be necessary to solve the problem. So beginning with the very first touchpoint that kids have, either in early education or in the school system, the recognition – and some of this good work is already happening through the Illinois State Board of Education that has wellness programs and trauma-informed intervention – but recognizing that this is the responsibility of all of these agencies, that they all play a role in addressing the needs of children with behavioral health problems, I think is going to be really important. And we’re already beginning to see some of that interagency collaboration in staffing and individual cases, and I think we need to see that more broadly and at the leadership level.