By the end of this year, emotionally disturbed Howard County youngsters and their families will be able to get mental health services in their own homes.
The county health department is launching a two-member home intervention team that will work with children 18 and under who have been discharged recently from state hospitals and residential treatment facilities.
It also will work with children in foster care, who are about to be placed in foster care or who are at risk of developing mental disorders.
"We're really trying to offer a variety of care," said Judith Phibbs, a clinical psychologist and coordinator of child and adolescent services for the county health department.
The home intervention team will be the first of its kind in Howard County, but the state health department says that 12 Maryland counties already offer such programs for youngsters.
Howard County's program is being set up through a $67,000 grant awarded six weeks ago by the National Institute of Mental Health.
The team will include a mental health assistant, who will provide transportation, and a social worker who specializes in family therapy and can direct children and their families to other county social service agencies.
In addition to the social worker and mental health associate, the grant will pay for training and a computer system to track clients' progress.
The health department also plans to train workers to defuse crisis situations.
The home intervention program calls for the social worker to visit 10 families several times a week, providing individual and family counseling.
The social worker will work with families disrupted by substance abuse, violence and divorce. The social worker will help the family discuss its problems and refer family members to therapists outside the program.
In addition, the social worker will refer families to social service agencies that provide treatment for addictions and help with affordable housing and other services.
"We would be working heavily with the school system and other agencies," Dr. Phibbs said. "We would see their problems globally."
By visiting people in their homes, public health officials said, they will gain better insight into the problems their patients face.
"You can get a much better view of how a family lives together," said Caren Klein, a social worker for the county health department.
Currently, county health officials keep in touch with troubled families through office visits and phone calls.
"We see them as often as possible," Dr. Phibbs said. "There are a lot of interagency meetings, a lot of phone contact, but there are clearly families who could benefit" from the new program.
Dr. Phibbs said community-based health programs for youngsters are gaining more support than they have in the past, though they remain outnumbered by programs for mentally ill adults.
"Research in psychiatry tends to emphasize adults," Dr. Phibbs said. "What the National Institute of Mental Health is trying to do is target funds just for children and adolescents."
In addition to the home intervention team, the health department offers an after-school program, summer camp and counseling services for disturbed youngsters.
The after-school program works with children ages 6 to 11 and meets two days a week at a health department office in Columbia. There, the children learn to cope with their anger, socialize with peers and resolve differences without violence.
Children work on socialization skills and learn how to swim during the summer camp.
Emotionally disturbed preschoolers can get counseling under a zTC program that began four months ago with Head Start, a program for low-income children ages 3 to 5 that seeks to prepare them for school.
"We're all trying to fill in the gaps," Dr. Phibbs said.