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Two major reform movements have shaped child and adolescent mental health services over the past quarter-century: the Systems of Care movement, and more recently, the movement toward evidence-based practice. Results from several studies indicate that youth served in traditional residential or inpatient care may experience difficulty re-entering their natural environments, or were released into physically and emotionally unsafe homes (Bruns & Burchard, 2000; President's Commission on Mental Health, 1978; Stortz, 2000; Stroul & Friedman, 1986; U.S. Department of Health and Human Services, 1999). The cost of hospitalizing youth also became a policy concern (Henggeler et al., 1999b; Kielser, 1993; U.S. Department of Health and Human Services, 1999). For example, it is estimated that from the late 1980s through 1990 inpatient treatment consumed nearly half of all expenditures for child and adolescent mental health care although the services were found not to be very effective (Burns, 1991; Burns & Friedman, 1990). More recent analyses indicate that at least 1/3 of all mental health expenditures for youth are associated with inpatient hospitalization (Ringel & Sturm, 2001).

While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to this topic has grown dramatically. Reforms that promote high-quality care as well as responsibility for total cost of care have shifted focus among health care providers toward upstream determinants of health care outcomes. As a result, there has been a proliferation of activity focused on integrating and aligning social and medical care, many of which depend critically on cross-sector alliances. Despite considerable activity in this area, cross-sector alliances in health care remain largely undertheorized. Both literatures stand to gain from more attention to carefully knitting together the theoretical and management literature on alliances with the empirical, health policy and health services literature on cross-sector alliances in health care. In this chapter, we lay out what exists in the current scientific literature as well as a framework for considering much needed work in this area. We organize the literature and our commentary around the lifecycle of alliances: alliance formation, including factors prompting alliance formation, partner selection, and alliance goals; alliance maturity, including the work of these cross-sector alliances, governance, finance and contracts, staffing structure, and rewards; and critical crossroads, including alliance timelines, definitions of success, and dissolution. We also lay out critical areas for future inquiry, including better theorizing on cross-sector alliances, developing typologies of these cross-sector health care alliances, and the role of policy in cross-sector alliances.

The purpose of this chapter is to apply structural functional theory and the concept of “unbundling” to an analysis of the deinstitutionalization and community mental health efforts that have shaped the current mental health services environment.

We examine the original goals of the institutional movement, the arguments supporting it, and the functions of the institutions that were created. We then examine the criticisms of that approach and the success of the subsequent deinstitutionalization process, which attempted to undo this process by recreating the hospitals’ functions in community settings. Finally, we address the question of whether the critical functions of psychiatric institutions have indeed been adequately recreated.

Our overview of outcomes from this process suggests that the unbundling of state hospital functions did not yield an adequate system of care and support, and that the functions of state hospitals, including social control and incapacitation with respect to public displays of deviance were not sufficiently recreated in the community-based settings.

The arguments for the construction of state hospitals, the critiques of those settings, and the current criticism of efforts to replace their functions are eerily similar. Actors involved in the design of mental health services should take into account the functions of existing services and the gaps between them. Consideration of the history of efforts at functional change might also serve this process well.

While Chapter 3 highlights contextual conditions that foster the formation of policy networks, Chapter 5 highlights contextual conditions that impede the formation of policy networks. The overarching question of this chapter is the following: What are the factors that hinder cross-sectoral arrangements from becoming collaborative in complex policy settings such as low- and middle-income countries with a tradition in centralized policy making? In an attempt to address this question, this study provides a detailed assessment of all cross-sectoral arrangements within the Turkish health sector focusing on the post-2003 period. Within this framework, three types of networks will be examined including (a) consultative networks where stakeholders come together primarily to legitimize certain government policies within national level health policy platforms; (b) cluster networks where stakeholder interaction falls short of becoming collaborative due to diverging interests and persistent competition at the regional level; and (c) patronage networks where governmental actors and a selected number of NGOs linked by clientelism serve as a bridge between the ruling party and its constituency at the community level. Unlike policy networks, these actor constellations observed at different levels of governance do not serve the purpose of policy collaboration. On the contrary, they have the potential to trigger politicization, fragmentation, and even polarization at the social level, especially through the distribution of selective benefits. Ultimately, this chapter aims to rise to the challenge of policy collaboration by assessing the impediments to network collaboration based on insights from the Turkish case.

This chapter draws from the authors’ experiences with service-learning pedagogy in allied health training programs, and illustrates ways in which community-engaged teaching and learning can prepare students to become ethical healthcare practitioners. The authors infuse examples from their own courses throughout the chapter, mostly from the clinical fields of speech-language pathology, audiology, and occupational therapy. However, the chapter is applicable and generalizable to faculty from a wide scope of allied health training programs. The chapter introduces considerations for establishing campus–community partnerships in an ethical manner, as well as ways to foster student self-reflection and critical thinking through an ethical lens. Principles from the codes of ethics of various allied health professions are incorporated throughout the chapter along with examples of how each can be applied in community-based clinical experiences. Through a review of relevant literature, analysis of professional codes of ethics, case-based examples, and a step-by-step guide to course development, this chapter provides readers with a mechanism to ground their courses in professional ethics in a way that is relatable and relevant to students.

This chapter describes a particular course that was undertaken as part of a partnership between three community institutions: a classroom of college undergraduate learners, residents of a local homeless outreach center, and the members of a neighboring social justice oriented Christian community. The project was an interdisciplinary endeavor, facilitated by the authors who represent the humanities, specifically Religious Studies and Education. The students in the course represented a cross-section of the institution where the authors teach: various majors, both declared and undeclared; students from different enrollment years; various ages; and mixed race and ethnicity. The first part of this chapter addresses a theoretical framework related to community-based learning and service-learning related to the role of such partnerships in higher education with specific focus on a particular course. The second part addresses the significance of the social change model and purposeful student self-reflection within such partnerships as a way to enhance student learning. The final part of the chapter includes an evaluation of the community collaboration with respect to process and student learning.

In Hawaiʻi, two public library systems exist – a traditional municipal branch system and a Native Hawaiian rural community-based library network. The Hawaii State Public Library System (HSPLS) is the traditional municipal library system that services the state’s diverse communities with 51 branch locations, plus its federal repository, the Hawaii State Library for the Blind and Print Disabled. The HSPLS primarily serves the local urban communities of Hawaiʻi, diverse in its citizenry. The Native Hawaiian Library, a unit of ALU LIKE, Inc. (a Hawaiian non-profit social services organization), boasts multiple locations across six inhabited Hawaiian Islands, primarily serving rural Hawaiian communities. The HSPLS focuses on traditional public library services offered by MLS-degreed librarians. In contrast, the Native Hawaiian Library (ALU LIKE) focuses on culturally oriented literacy services offered by Hawaiian cultural practitioners. As the state’s only library and information sciences (LISs) educational venue, the University of Hawaiʻi at Mānoa’s LIS program (UHM LIS) is a nexus point between these two library systems where LIS students learn the value of community-based library services while gaining the traditional technical skills of librarianship concerning Hawaiʻi as a place of learning and praxis.

This book chapter focuses on outcomes from the IMLS-funded research project called “Hui ʻEkolu,” which means “three groups” in the Hawaiian language. From 2018 to 2021, the HSPLS, the Native Hawaiian Library (ALU LIKE), and the UHM LIS Program gathered as “Hui ʻEkolu” to create a community of praxis to share and exchange knowledge to learn from one another to improve professional practice and heighten cultural competency within a Hawaiian context. Native Hawaiian values were leveraged as a nexus point for the three groups to connect and build relationships for sustainable mentorship and culturally competent connections as a model for librarian professional development. The result is a model for collective praxis that leverages local and endemic cultural values for sustainable collaborative professional development for public librarianship.

The belief that children have mental health needs different than those of adults is a relatively recent phenomenon. Systematic field studies of mental illness began in the early 19th century (Anthony, Eaton, & Henderson, 1995), although awareness of these illnesses and the recognition of the need for treatment were well established by the 1600s (Grob, 1994). Field studies and census data from mental hospitals in the 1800s reveal few cases of mental illness identified among children under the age of 16. In the late 19th and early 20th centuries, the recognition that children have specific mental health needs arose as the result of the confluence of several factors. The Progressive Movement promoted child labor and mandatory public education laws that created legal separations between the role of children and adults (Abbott, 1908; Sutton, 1983). Hall (1905) helped popularize the idea that childhood and adolescence constituted distinct periods of development. Perhaps most pressing, however, was a perceived rise in juvenile delinquency and sexual promiscuity. To address these problems, separate courts were established for juvenile offenders to keep children out of institutions and to provide treatment and rehabilitation (Alper, 1941). Based on the work of Healy and Bronner (1916), researchers and policy makers began to think of juvenile crime as arising from “mental conflicts” in children. Institutions such as the Chicago Juvenile Psychopathic Institute and the Boston Psychopathic Hospital were established to care for these children (Horn, 1989).

The purpose of this study was to re-examine racial and gender differences in home and community-based services utilization. Using the 1999 National Long Term Care Survey, the Anderson-Newman (1995) health behavioral model, social supports and structural factors were used to examine predictors of service use among four in-home and two community-based services. The results showed that race did not have a significant main effect on service use, but gender had a significant main effect for housework, home delivered meals, and congregate meals. Using an interaction term, older white women reported higher usage of housework. Among the predictors, enabling factors had the strongest effect on the use of personal care/nursing, home delivered meals, transportation and senior centers’ services. The results also indicated the importance of social supports and structural factors, particularly service awareness, in predicting service use. Implications for policies and practice to improve community outreach, access and utilization of services by different racial groups of elders are discussed.

Public schools possess a unique constellation of opportunities and challenges for mental health service provision. Schools, as settings within a larger ecological context, can be a community institution that supports a child as s/he develops assets for resilient development while providing opportunities for a range of life choices. School is the setting where children can learn and practice peer relations and social norms, and it can be a refuge where children who have many environmental risks can find structure and effective methods of success (Doll, 1999). When Willie Horton, the infamous bank robber, was asked why he robbed banks, he responded, “Because that's where the money is.” At a most basic level, schools are where the children are. Every day more than 52 million students attend over 1,14,000 schools in the United States, and including the 6 million adult staff, this amounts to almost one-fifth of the population passing through the Nation's schools on any given weekday (New Freedom Commission on Mental Health, 2003).