All too often, children whom teachers say are ‘acting out’ or who are in conflict with family members at home are actually struggling with mental health. Experts estimate that as many as 41,000 children in Massachusetts have unmet mental health needs, and nearly 17,000 of those youth qualify for an Individualized Education Plan in school owing to an identified emotional disturbance. The Mental Health Advocacy Program (MHAP) for Kids, operated by Health Law Advocates (HLA), is one of the most consequential programs for families in the Commonwealth of Massachusetts, ensuring children with mental health issues receive the services and supports they need. The program’s goal is to divert children from unnecessary involvement in the juvenile justice system solely due to their mental health needs. Mental Health America reports that 65 to 70 percent of children involved in the juvenile justice system have a diagnosable mental health condition, and this involvement is often avoidable. The Tower Foundation is proud to be HLA’s grant partner and of MHAP’s status as one of our longest-running grants.
Unmet child mental health needs are one of Massachusetts’ most glaring service gaps. These children’s issues worsen and become more complex when their needs are not met. They may struggle in school, be psychiatrically hospitalized or sexually exploited, or run away from home. In 2005, HLA began using legal advocacy to divert children with mental illness from juvenile courts to treatment. After developing its children’s mental health practice over time and witnessing increasing demand and evidence of its effectiveness, HLA established MHAP in 2012 to pursue the optimal service delivery model, statewide expansion, and program sustainability through state investment. MHAP initially placed specially-trained attorneys (advocates) directly in juvenile courts to help children with cases in the system receive mental health services and exit the court system—serving an important role helping children and their families navigate what is otherwise a foreign system to them.
MHAP’s advocates, who are familiar with the juvenile justice system and its challenges, are able to make this system more approachable for families, and in some cases, help them avoid it altogether. As just one example, Avante is a boy who was restrained by police at school because neither his teachers nor the officers who arrived on the scene knew how to handle this seven-year-old boy with autism. A MHAP attorney represented Avante and his family and advocated for him at individualized education program (IEP) meetings to ensure his teachers understood his situation. When that still did not lead to improvement, MHAP advocates worked to help the family enroll Avante in a private, special education day school. Having avoided the juvenile detention system, Avante is now happy and thriving.
We are proud of the way the program evolved and its nimbleness when facing challenges. After a couple of years of working in the juvenile court system, it became evident that the original plan to sustain the program through the courts wasn’t going to work out. HLA’s leaders were nimble and rethought the model, placing its advocates in Family Resource Centers throughout Massachusetts. These Family Resource Centers are also designed to divert children with mental health needs from the court system and do so in various ways from linking families to social services, to responding to family crises, to offering help with parenting skills. The partnership between Family Resource Centers and the MHAP resulted in a strong and lasting safety net for children living with mental health needs and their families.
Our strongest grant partners demonstrate a willingness to change course when presented with significant challenges. It would have been easy for MHAP leadership to throw their hands up, sit back, and give up. Instead, they kept us well informed about the program’s latest developments when the original sustainability plan began to meet significant headwinds, as well as their progress on the alternative approach via Family Resource Centers. A trusting, transparent partnership is key to our mission. Likewise, when funding got tight, we were open with MHAP about it, and worked hand-in-hand with the organization in order to ensure it received the grants needed for a managable budget , but more importantly, its effectiveness. Transparency with partners is vital in grantmaking. It builds trust and stability.
“Families tell us all the time that the ability to work with an attorney has made a life-changing impact on not only the child, but on the entire family,” said Amy McCarthy, past Boston Family Resource Center Program Director. “Our mission is to do whatever it takes to help these families. That includes pairing them with a lawyer who shares the family’s goal of keeping their child out of the juvenile justice system if at all possible.” This partnership with an organization that has the very same mission was a recipe for a long-lasting, life-changing impact.
MHAP’s work speaks for itself, and Massachusetts leaders have noticed. Before FY (fiscal year) 2018, MHAP was paid for almost exclusively through grants and donations. Between FYs 2018 and 2021, state funding for the program grew nearly 20-fold—from $50,000 to $950,000—and it’s making a measurable difference. Researchers at Boston University’s School of Public Health found that when MHAP intervened, the children it serves experience improved school attendance and overall mental health and decreased use of emergency mental health services, inpatient hospitalizations and stays in emergency shelters and residential facilities. Through this increased state funding, MHAP has also reached its goal of serving children statewide. We are tremendously enthusiastic about MHAP’s work and proud to be HLA’s grant partner.