This semester I have been doing my field placement at St.

Clair County
Community Mental Health. They provide services for individuals with mental
health illnesses and substance abuse problems who have Medicaid or who
qualify for other public insurance plans. The mission statement for
Community Mental Health is, Promoting Discovery & Recovery Opportunities
for Healthy Minds & Bodies. Some services offered include adults with
mental illnesses, children with serious emotional disturbances, adults and
children with intellectual or developmental disabilities, adults & children with
substance use disorders, and adults with co-occurring mental health &
substance use disorders. They also have emergency crisis services that are
open to anyone who needs them during crisis times. They aim to promote
recovery with these services instead of just treating the mental illnesses and
disabilities that the clients have.
The clients seen at Community Mental Health vary in age, gender,
race, and illness. They can be anywhere from a 2 year old who was
diagnosed with autism to an 80 year old with schizophrenia. The only real
similarity between all of the clients is that most of them are in a lower
income level and have Medicaid as their primary health insurance. The main
clients seen in the department I have been working in are children under 18
who have developmental disabilities, DD, or severe emotional disturbances,
SED. There are many different programs for these children to be enrolled in
where they can learn social skills, coping skills, and life skills. Most of the
programs are free to these people.

Like I said before I primarily work with children. I am evenly split

between developmental disabilities and severe emotional disturbances.
Three of my kids are all on the autism spectrum. They are all very sweet kids
who are all going through different experiences and challenges, which is nice
for me to see the differences between these children. My other three kids are
all on the severe emotional disturbance side. These children have issues with
making friends and are often in trouble. They are also very sweet children
who just need some extra support to work through everything they have
gone through in their lives so far.
On Mondays I have the most meetings with them. First, I am with an
autistic boy who is in middle school. I will play games with him and talk to
him about how school is going. He has had issues with school before and has
a severe fear of bugs, especially bees. I have been working with him to learn
his triggers while at school and how to handle his fear of bugs when he is
away from home. He has made great progress with the bugs as we were able
to be outside almost all day on our last visit. My second meeting is with two
of my SED children. I will take them out into the community to a park and let
them play together for the hour. They do very well together, which is part of
their plans to learn how to cope with their frustrations with peers. They have
begun to look to each other when they need help, which is exactly what we
want them to learn.

On Tuesdays I have another three clients I see. First, I see an autistic

boy who is in elementary school. My job with him is to model good coping
skills for anger since he has had issues with it in the past. He has had a lot of
issues with peers in his class making fun of him and has had to switch
classrooms twice this year because they had too many kids. This is what
makes him frustrated so I try to help him cope with that. My second meeting
is with two boys at the same time, who I also see on Thursdays. One is
severely autistic and the other is a severe emotional disturbance. They both
live with their foster father after his partner who was their adoptive father
passed away earlier this year. The autistic boy is completely non-verbal and
is very hard to communicate with. He has had a large increase in aggression
since his fathers death and many medical problems. As of now my role with
him is to give his foster father someone to talk to about what has been going
on. The other boy who has Oppositional Defiance Disorder just needs
someone to set rules for him. I help him with homework and play games with
him to keep his energy level at a manageable level. I model coping skills and
give him someone to talk to regularly about his actions and what is
acceptable behavior and what is not. Overall, my main job is to help these
children grow with good skills that will help them transition into adulthood.
There are other programs for the adult population the agency sees, but I do
not work with them so I am unaware of what they do.
To access the services it is fairly simple. For childrens, it really
depends on what they are diagnosed with. To get into the SED program the

child must have MiChild insurance and go through the Access number we
provide. After they call the Access number they will be scheduled to meet
with an intake nurse or social worker. The person doing the intake will then
decide if they qualify for services. To qualify for the DD program, children
must have a specific diagnosis or group of diagnosis. We do not see children
who are only diagnosed with ADD or ADHD; they must have another
condition to qualify for either DD services or SED services. Once they are in
one of the two programs they will be assigned a worker within the childrens
department who will then go through the process of finding what services
they child would benefit from.
Once these children are in the system they will do large annual
assessments and periodic reviews throughout the year. Every year the
worker will go to the childs home to do their Individual Plan of Service and
Biopsychosocial assessment. During this meeting the worker will discuss with
the parent and child what is working for them, what is not, and what changes
they wish to make. They will then create goals that either the child wants to
meet or the parents want them to meet by the end of the plan. Using this
plan they can decide what services the child qualifies for and what services
they will receive. Most children will all receive the monthly medication
reviews and individual counseling. The other services are on an individual
basis. After this meeting the worker will meet with the child every three to
six months for their periodic review. During these reviews they will discuss
progress on the goals in the plan and see if any changes need to be made. If

any changes are made during these meetings, they will only be in effect until
their next annual Plan of Service meeting, and then everything will be
reevaluated.
Termination of services is very different for the two groups of children
we see. Most of our DD children will continue to receive services. Since these
children will always have their developmental disability they will just age out
of childrens. Once they turn 18, they will often just be transferred to the
adult department and continue to receive their services. The SED children
are where it can get a little confusing. Every three month the SED children
will be evaluated to see what their CAFAS score is. Once their CAFAS score is
below 50 they will begin the process of being discharged from the SED
program. If they never get below the CAFAS score of 50 they will age out of
the program when they turn 18. Once they turn 18, the services with the
childrens department will be terminated and they will have to reapply to the
adult program. In order for the SED children to receive adult services they
have to meet a whole new list of requirements and often have some sort of
mental illness diagnosis.
St. Clair County Community Mental Health is very committed to the
community around it. The Community Mental Health website states, St.
Clair County CMH is a valued and essential part of the communities it serves.
St. Clair County CMH seeks meaningful ways to provide supports in response
to under met or unmet community needs. St. Clair County CMH believes that

accountability to and responsibility for the local community is essential and

will strive to develop partnerships that create opportunities, takes measured
risks, advances creativity, and challenges the status quo. We do many
different activities in the community. There was a suicide walk the CMH
sponsored in September, which had a great turn out. They also participated
in the roof sit at the Birchwood Mall to raise money and awareness for child
abuse. They just started a program that will go to all the different elementary
schools in the area and talk about different disabilities with the children to
try and get rid of stigma in schools.
Overall, I have really loved my internship at CMH so far. Over the next
few weeks I will be beginning to do the annual Biopsychosocial assessments
and annual Individual Plan of Service meetings. This means I will begin to
understand how to determine what services the children need and how to
make sure they are getting everything they need. I will also be starting
CAFAS training so I can learn more about our discharge process. This has
really taught me that this is the environment I truly do want to be in and that
I did get lucky when choosing my placement.