Chicago Children’s Advocacy Center: PATHH Collaboration
Since 2010, Chicago Children’s Advocacy Center (ChicagoCAC) has received grants totaling $140,000 from the Michael Reese Health Trust supporting the start-up and development of the Providing Access Toward Hope and Healing (PATHH) Collaboration. The Health Trust was one of the first foundations to invest in PATHH and, in partnership with the Lloyd A. Fry Foundation, helped spark the project and bring other foundations to the table.
PATHH links child victims of sexual abuse and their families to trauma-informed, evidence-based mental health care within a network of 16 specialized mental health providers. During its first nearly three years, PATHH development has included 1) creating a triage system that assesses children’s mental health state and prioritizes them for therapy services, 2) creating a streamlined referral and follow-up system among the 16 agencies, 3) developing a curriculum and implementing psycho-educational groups to provide fast access to mental health support, and 4) increasing the capacity of mental health agencies in Chicago to provide evidence-based, trauma-informed care to meet the demand for services.
Brief Agency Overview
ChicagoCAC and its partners are the front-line responders dedicated to restoring the lives of thousands of Chicago children who are sexually and physically abused every year. ChicagoCAC’s partners include the Illinois Department of Children and Family Services, Chicago Police Department, Cook County State’s Attorney’s Office, and Cook County Health & Hospitals System. More than 120 professionals from all five partner agencies work together under one roof to investigate reports of child abuse and protect suspected victims. ChicagoCAC responds to nearly 2,500 reports of sexual abuse (ages 0-17) and severe physical abuse (ages 0-3) per year in Chicago.
ChicagoCAC is the lead agency and fiscal agent of PATHH. Partner agencies include:
- Advocate Childhood Trauma Treatment Center
- Ann & Robert H. Lurie Children's Hospital of Chicago
- Association House
- Casa Central
- Catholic Charities
- Center for Contextual Change
- Chicago Children’s Advocacy Center
- Children’s Research Triangle
- Community Counseling Center of Chicago (C4)
- Jewish Child and Family Services
- Juvenile Protective Association
- La Rabida Children’s Hospital – Chicago Child Trauma Center
- Mount Sinai Hospital’s Under the Rainbow Program
- Uhlich Children’s Advantage Network (UCAN)
- UIC Clinic for Developmental Disabilities
- YWCA – RISE Children’s Center
$100,000 over three years
PATHH’s five-year start-up goals include:
- Increase system capacity for trauma-informed, evidence-based therapy services.
- Significantly reduce the wait time for therapy for children who have experienced sexual abuse and are triaged as high priority.
- Increase engagement in mental health services for families referred through PATHH.
- Share the lessons learned from PATHH with other service delivery systems.
In its first nearly three years, PATHH has developed a well-coordinated system for linking children to mental health services. Highlighted below are several key components of PATHH developed with grants from the Michael Reese Health Trust. PATHH has the potential to inform the development of similar systems of mental health care throughout the country.
Centralized Wait List (CWL): PATHH launched a CWL on April 1, 2012. ChicagoCAC maintains information regarding capacity at the PATHH partner agencies, maintains contact with each family while they wait, and links families to open slots as soon as they become available. Key goals of the CWL include reducing wait times and improving client engagement rates; In addition, establishing baseline measures of related outcomes has been a top priority of the past year.
For example, thus far, of the CWL data has led to a better understanding of the challenges in reducing wait lists and increasing engagement and has improved systems to address those challenges. Prior to the CWL, families were referred to multiple agencies, with no true idea of capacity and engagement. PATHH now has daily information on the number of families waiting, and the capacity of the system to enroll families in counseling services. By maintaining contact with clients while they are on the wait list, PATHH has improved the likelihood that these clients engage appropriately in services as soon as a spot becomes available at one of the PATHH partner agencies. This improved communication benefits the clients, and it also reduces duplication of services by PATHH partners (who no longer have to expend their own resources to track down and engage referred clients).
- System capacity as reported by providers during January, February, and March (quarter three of FY13) was 256, 262, and 268 respectively. Of these available slots, 230, 231, and 233 were filled in the respective months. This reflects utilization rates of 90%, 88%, and 87%. It also reflects that the number of children in services, after increasing 11% during the previous quarter, have remained steady throughout this quarter.
- During the first two quarters following full implementation of the CWL (July 1 – December 31, 2012), the wait time averaged 90 days. It’s estimated that previous wait times may have extended even longer, but since centralized tracking is new to this collaboration, tracking wait time will continue in order to measure future progress from this 90-day “baseline” in reducing the average wait time.
Expansion of Resources: PATHH has reserved 50 therapy slots at four partner agencies for high priority children through the Expansion of Treatment Capacity Project. The project includes the piloting of new case referral, intake, and management practices aimed at increasing client engagement in therapy. In addition, since August 2012, PATHH has added four new member agencies, bringing the total to 16.
Hope and Healing Groups: Children with a lower triage score, those who opt out of mental health services, or those who are waiting for individual therapy may elect to join a psycho-educational Hope and Healing Group. Groups for children and caregivers have been established at five sites around Chicago and run year-round. In the first year of full implementation (FY12), 77 families attended a total of 110 Hope and Healing Group sessions. 99% reported that the group was helpful to the child and caregiver. An adolescent Hope and Healing Group was piloted at ChicagoCAC February 21 to March 28, 2013, with five families actively participating. Two more adolescent groups are scheduled at partner agencies during FY13.
Evaluation: Data and evaluation are key elements of the PATHH Collaboration. The Juvenile Protective Association (JPA) is conducting a longitudinal analysis of engagement in mental health services through PATHH. The most recent evaluation report from JPA analyzes referral data collected from January 1, 2011 to September 30, 2012, with engagement data through June 30, 2012.
- Since the establishment of the CWL April 1 through March 31, 2012, PATHH has achieved a 34% engagement of children referred to mental health services from the CWL, compared to 30% previously. This increase demonstrates the system efficiencies of the CWL structure.
- Overall initial engagement rates continue to be higher for high priority families versus moderate priority families (35% compared to 16% this quarter). The lower engagement rate of moderate priority families reflects the concerted effort to prioritize high priority families as well as the limited capacity of the system.