The Evolution of Systems of Care for Children's Mental Health: 

Forty Years of Community Child and Adolescent Psychiatry

Andres J. Pumariega, M.D., Nancy C. Winters, M.D., and Charles Huffine, M.D.

Over the past 20 years, child and adolescent community mental health has evolved conceptually, clinically, and scientifically towards the community-based systems of care model.  This model asserts important values and principles, including the centrality of the child and family in the care process, the integration of the efforts of disparate agencies and interveners into contextual approach, and the importance of serving children with serious disturbances in their homes and communities.  The article reviews the evolution of the community-based systems of care model, its evidence-base, its application in practice, and the challenges it faces in today's human services environment.


This article may be read in its entirety in the Community Mental Health Journal, Vol. 39, No. 5, October 2003 pages 399 to 425.


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