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To help ensure that children with social and behavioral health problems get the support services they need, organizations collaborate in cross-sectoral networks. In this article, the authors explore and compare the structure of these complex child service delivery networks in terms of differentiation (composition) and integration (interconnection). In particular, the authors investigate the structure of client referral and identify which organizations are most prominent within that network structure and could therefore fulfill a coordinating role.

The authors used a comparative case study approach and social network analysis on three interorganizational networks consisting of 65 to 135 organizations within the Dutch child service delivery system. Semi-structured interviews with the network managers were conducted, and an online questionnaire was sent out to the representatives of all network members.

The networks are similarly differentiated into 11 sectors with various tasks. Remarkably, network members have contact with an average of 20–26 organizations, which is a fairly high number to be handled successfully. In terms of integration, the authors found a striking diversity in the structures of client referral and not all organizations with a gatekeeper task hold central positions.

Due to the scarcity of comparative whole network research in the field, the strength of this study is a deeper understanding of the differentiation and integration of complex child service delivery systems. These insights are crucial in order to deliver needed services and to minimize service silos and fragmentation.

In 2020, UNICEF Canada released Report Card 16 revealing that Canada ranks in the bottom tier compared to other wealthy countries in terms of child and youth well-being. The Report Card highlights that promoting participation is required to improve this ranking. Recognising the connection between child well-being and participation, this chapter explores youth-serving institutions in Canada to understand how participation materialises in these settings. Through interviews with provincial and territorial Canadian child and youth advocates, this chapter first explores advocate offices that serve young people facing challenges. These are the only group of child and youth advocates in Canada that have formal legal mandates to implement children's rights at the provincial and territorial level. Comparatively, through interviews with justice-involved youth we analyse the youth justice system. By adjusting the setup of the court space and attempting to minimise power imbalances, we discuss how Canada's first and only Aboriginal Youth Court (AYC), promotes participation and engagement. Through a comparative case analysis, this chapter explores where barriers exist in terms of conceptualising and implementing participation rights, and where opportunities and best practices may be leveraged across child and youth serving institutions in Canada.

Systems of care and evidence-based practice possess distinct histories. Though each developed out of attempts to improve services to youth with emotional and behavioral disorders, they did so from perspectives so different as to appear diametrically opposed. Service systems exist at multiple levels, including the practice, program, and system levels (Rosenblatt, 1988, 2005; Rosenblatt & Woodbridge, 2003). Research on health and mental health service systems similarly varies, often by level of the service system, with the research methods, independent and dependent variables, populations of interest, and ultimately the consumers of the research product interacting differentially in the creation and understanding of what constitutes a knowledge base for service delivery. Systems of care and, with limited exceptions, evidence-based practices exist at different levels of the service delivery structure, require and derive from different research approaches, and speak to overlapping but historically different audiences.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

The purpose of this paper evaluates the capacity of the Cornwall Foundation Trust (CFT) of the National Health Service (NHS) to implement the UK Government’s children and young people’s mental health strategy through its school-based integrated health centre (SBIHC) delivery model.

This evaluation uses six case studies of SBIHCs to indicate the general effectiveness of this delivery model and its capacity to implement the three core proposals of the Government’s strategy. The core proposals are: to encourage all schools and colleges to identify and train a designated senior lead (DSL) for mental health; to fund new mental health support teams (MHSTs); and to develop strategies to meet the proposed four-week waiting time for access to specialist NHS mental health services.

This evaluation found that the Duchy Health Charity and CFT piloted a new delivery model in three SBIHCs from 2009 that successfully integrated health and educational services to children and adolescents, including general health and well-being and sexual and mental health and, more recently, integrated welfare services.

The main research implication is that longitudinal case studies of organisational innovations can reveal the subtleties of educational management in context and potentially inform advances elsewhere consistent with national policy developments.

The main practical implication is that the SBIHCs at Penair Community School, Budehaven Community School, Hayle Community School, Looe Community Academy, Treviglas Community Academy and Wadebridge Community School should each be recognised as a “trailblazer site” in the implementation of the Government’s children and young people’s mental health strategy.

Mandatory secondary education is the last opportunity that the UK society has to embed knowledge, skills and attitudes needed for the life-long self-management of health. The CFT’s SBIHC model trialled since 2009 has successfully integrated health and educational services to children and adolescents, including general health and well-being and sexual and mental health and, more recently, integrated welfare services.

This evaluation research is unique. It reports that the CFT’s SBIHC model is the first and only organisational innovation at a system level in the UK that has successfully integrated health and education services to children and adolescents.

This chapter examines the context for the implementation of the global commitment to early childhood education (ECE) within the framing of the sustainable development goals (SDGs) under SDG 4.2. We first define the concept of ECE as broadly understood in the field of education and in practice related to a focus on education of children. The essay adopts chronological age of children served outside of the formal school system, which has traditionally been recognized as basic education, to represent the population captured under ECE in both pre-school and pre-primary settings. UNICEF identifies those ages 3–6 to fall into this category. We present an exploration of the challenges and opportunities presented by multiplicity in multilateral agencies and other agencies driving the international initiatives around advancing ECE and the means by which they promote education opportunities for children. We offer a comparative perspective on the delivery, types, and funding mechanisms of ECE services in both developing and developed country contexts, which informs the possibilities for the realization of the SDG goal of inclusive quality education for all. An examination of the socio-cultural and economic context of accessibility to inclusive and equitable quality ECE is also presented. An overview of settings within which ECE is provided is interrogated within differing national contexts. We conclude with challenges and opportunities for sustained accountability, monitoring and evaluation of SDG 4.2 interventions from a comparative perspective.

A system of care is a function-specific, rather than agency-specific approach defined as a “comprehensive spectrum of mental health and other necessary services which are organized into a coordinated network to meet the multiple and changing needs of children and adolescents with severe emotional disturbances and their families” (Stroul & Friedman, 1986). A system of care provides a mental health delivery system for children with SED with a wide array of accessible, community-based services that focus on children's individual needs, include the family in treatment planning, and provide culturally competent services. System of care services are provided by multiple child serving agencies and are collaborative and coordinated (Stroul & Friedman, 1986).

Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on health and social care delivery in the community: they require dynamic and responsive health and social care over a long period of time; they require organisational and delivery coordination functions; and health issues such as minor illnesses, normally presented to primary care, must be addressed in the context of the complex health issues. Their clinical presentation may challenge local care management. The project explored the interface between primary care and specialised health services and found that it is not easily navigated by children with CCNs and their families across the European Union and the European Economic Area countries. We described the referral-discharge interface, the management of a child with CCNs at the acute–community interface, social care, nursing preparedness for practice and the experiences of the child and family in all Models of Child Health Appraised countries. We investigated data integration and the presence of validated standards of care, including governance and co-creation of care. A separate enquiry was conducted into how care is accessed for children with enduring mental health disorders. This included the level of parental involvement and the presence of multidisciplinary teams in their care. For all children with CCNs, we found wide variation in access to, and governance of, care. Effective communication between the child, family and health services remains challenging, often with fragmentation of care delivery across the health and social care sector and limited service availability.

Adverse childhood experiences that are consistently experienced over a sustained period of time throughout childhood result in an accumulation of childhood adversity, which is often referred to in the literature as cumulative harm. This paper aims to closely examine statutory child protection practice, which favours an episodic and incident-focused approach to assessing risk and harm, failing to account for the evaluation of the accumulation of adversity and harm, commonly experienced by children exposed to maltreatment. The paper defines an existing gap in practice frameworks to adequately identify and respond to the accumulation of adversity.

Drawing on practice experiences in Queensland Australia, the paper examines service delivery responses to cumulative harm in the context of the Intensive Family Support model of service delivery.

Within current frameworks for child protection service delivery, there is no method of assessing the diverse and cumulative effects of ongoing chronic child maltreatment and adversity, despite research confirming that cumulative harm very often co-occurs with other child protection concerns. To effectively and collaboratively intervene in matters of chronic and cumulative abuse and neglect, practitioners and stakeholders must be guided by frameworks and assessments that accurately recognise and acknowledge the impact of ongoing exposure to adverse experiences and maltreatment.

The need for a valid and reliable assessment method that draws together all elements contributing to the chronic maltreatment experience for a child and family: multiplicity, diversity and severity.

Practice solutions tailored to each child’s specific cumulative experiences of adversity and maltreatment will promote better social, emotional and health outcomes across the lifespan.

This paper highlights a significant gap in assessment and practice frameworks and advances the impetus for cumulative harm to be proactively integrated into social care and service delivery.

To achieve a full understanding of the role of marketing from plan to profit requires a knowledge of the basic building blocks. This textbook introduces the key concepts in the art or science of marketing to practising managers. Understanding your customers and consumers, the 4 Ps (Product, Place, Price and Promotion) provides the basic tools for effective marketing. Deploying your resources and informing your managerial decision making is dealt with in Unit VII introducing marketing intelligence, competition, budgeting and organisational issues. The logical conclusion of this effort is achieving sales and the particular techniques involved are explored in the final section.