Dual-diagnosis, fallen between the cracks,
cross-systems kids...

No matter what words you use to describe "these kids" there is a place for them in System of Care.  That isn't to say that it is any easier to determine what services they need and what system is responsible for that child's care, but what is important for you to know is that if this happens to you and your child, that you have somewhere to go for guidance and family support, contact Better Days Ahead.

"Complicated kids" include kiids that are dually diagnosed and/or in more than one system (or referred to as cross systems.)  For example, a youth who is being treated for substance abuse and a mental health issue, such as bi-polar disorder, would be considered a dual diagnosis.   An example of cross systems would be a youth who is in foster care and in the mental health system.  Both of these scenarios sometimes leads people to refer to these youth as "complicated kids."

Sometimes, if a child is dually diagnosed they can become the “fall between the cracks” kids because the systems themselves may disagree about “where” is the best fit and meanwhile needs continue to go unmet.  Sometimes the answer is that they really belong is in both systems, but that can be difficult to figure out based on eligibility requirements, funding, and other regulations.  You can see that it can get really complicated, really quickly, as well as frustrating.

Developmental delays and mental health issues

Another example of a “complicated kid” might be a child that has development delays, and also has mental health issues.  It can be difficult to decide what is causing this child’s difficult behavior.  One of the challenges with behavior is that providers usually have to make a best guess about what is causing it.  And when guessing about causes for those difficult behaviors are made then those assumptions are used to guide the interventions... as you can see, there is a lot of room for "hit or miss."

For example, if based on an assessment, the assumption is made that a child is looking for attention then the intervention might include giving him/her positive attention sooner or more often.  If, on the other hand, I assume that a child is lacking a skill that is necessary which is leading to the behavior then the provider will try to teach (or find someone to teach) him/her the lacking skill.

You can see why these kids are referred to as complicated.   

Multiple challenges that cross different systems

Cross-systems kids include kids who have multiple challenges that cross into different systems.

For example, if a child has a history of trauma and depression and also uses marijuana, they may have needs that could be met through mental health services and substance abuse services.  In addition, the substance abuse may lead to involvement with the juvenile justice system.  If grades drop or there are other problems at school, the school system may also become involved. 

Another example, if a child has a development disability which impacts his ability to understand what people say and he has ADHD it may be difficult to know why he becomes frustrated when asked to follow directions.

The bottom line is that these kids may need a team of people working with them to sort out what is going on.  If you find yourself in this type of situation and you are struggling with finding the answers or aren't sure how to move forward then contact Better Days Ahead at 585-325-3145.

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