How MST Came to Ohio
In the mid-1990s, the Ohio Department of Youth Services (ODYS) underwent research that revealed significant barriers to meeting the mental health needs of the incarcerated youth in their care. Motivated to address this, the department began looking for alternative treatments for delinquent youth – a search that quickly led to Multisystemic Therapy (MST).
At the time, there were already a handful of MST teams operating in Ohio, but the state soon embarked on an initiative to greatly expand access. In 2000, the Ohio Department of Mental Health formed the Center for Innovative Practices (CIP), a center of excellence focused on bringing MST to interested communities across the state.
Today, CIP supports 12 MST teams in 12 counties across Ohio. The program relies on a diverse stream of funding sources, braiding funds from Medicaid, state grants, and county mental health and recovery services boards. Some provider agencies have started billing for treatments through private insurance, allowing the program to serve a broader population.
At the state level, the Ohio Department of Youth Services (ODYS) provides key funding that enables MST to serve a broad population of youth across the state. Also at the state level, the Ohio Department of Mental Health and Addiction Services (OMHAS) helps to support activities that educate communities about evidence- and community-based treatments.
At the local level there are countless champions across systems, from advocates in county mental health and addiction services boards, to supporters in juvenile courts, to promoters in children’s services systems. All of these champions understand the value MST brings to their communities, and are committed to supporting the program.
“We could not be happier with MST and the services that they provide for our youth and families. The home based model overcomes many of the challenges that a county of our size deals with on a regular basis. By engaging the family and other key community supports, the court is not sending rehabilitated youths back into the same dysfunctional environment.”
- Judge Albert Camplese, Ashtabula County Juvenile Court
Strengths of MST in Ohio
Ohio’s use of multiple funding streams is one of the program’s greatest strengths. Braiding funds from diverse sources is a highly recommended practice for MST, and Ohio has figured out how to effectively use Medicaid funds, state grants and local funding to support their MST teams. The program strives to ensure that all youth, regardless of their Medicaid-eligibility, can access MST without cost being a barrier.
In particular, ODYS’ RECLAIM Ohio initiative is a valuable funding resource. RECLAIM is a grant program that provides funds to services that divert youth from incarceration. The program then takes the savings from reduced youth incarceration and reinvests them in community-based therapies, providing a sustainable funding source. More recently, leaders at CIP were part of group in Ohio that have successfully advocated for a Medicaid rate increase, which will allow them to nearly double the amount of reimbursement they can bill per hour.
Ohio’s MST program is an excellent example of the importance of having braided funding streams. By relying on grant funding, as well as on local support, the MST teams in Ohio are more resilient and can better handle funding challenges.
Ohio has also been successful in leveraging regional collaboration to provide MST in rural areas, which typically have struggled to access home-based EBPs. Providers have been able to serve rural areas by creating anchor facilities in larger communities and developing regional branches to serve rural populations. Ohio’s Department of Youth Services has supported this approach through regional grants and collaborative support.
Finally, MST teams in Ohio have dealt with a shortage of qualified applicants to fill MST positions. They have overcome this by reaching out to colleges and universities to communicate the benefits of a career in MST. Teams have learned that presenting MST as a unique training opportunity for new clinicians who are working toward licensure can be effective. Graduate students realize that MST therapist positions will expose them to a variety of systems, which will be invaluable for their professional development.