Changing Patterns of State Responsibility: A Case Study of North Carolina

Over the past two decades, there has been an increasing focus on the needs of children with mental health problems. Although there has been a commitment to developing a continuum of child mental health services by mental health professionals and others involved in the treatment, education, and care of children, progress has been remarkably slow. The state of North Carolina, in response to litigation, has established a precedent by developing integrated systems of services for seriously behaviorally disturbed children and adolescents that may serve as a model for others. The North Carolina mental health system, primarily through the community mental health centers, has served as the lead agency in this initiative. After 4 years o f program development, it appears to be well established that seriously disturbed youngsters can be served in community based systems, especially in a strong and expansive case management function is in place.