Unclaimed Children revisited: the status of state children's mental health service systems.

In 1982, Jane Knitzer's Unclaimed Children described continued nationwide failure to provide services for children and adolescents with serious emotional disturbances. Since 1982, there has been considerable change in the philosophy, administration, and operation of services for this population. The current study compared state child and adolescent (C/A) mental health systems to those described in Unclaimed Children. Present findings are based on surveys of State Mental Health Representatives for Children and Youth in 1988/89 and 1993. Results indicated a marked increase in the number of state administrative offices and staff for C/A mental health. Much pertinent legislation had been passed. States developed a target population definition and largely officially embraced the Child and Adolescent Services System Program (CASSP) principles of an ideal system of care. Out-of-state placements were high, and placements on adult wards still existed. Counts of these placements were often unavailable to mental health officials.