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The engagement of families of children and adolescents with Serious Emotional Disturbance (SED) as full partners in individual treatment, organizational, and system level decision making has become an important focus for systems of care (SOCs) serving youth with emotional and behavioral challenges. SOCs typically include cross-agency partnerships with mental health, child welfare, juvenile justice, and education for the purpose of providing services and supports for youth with SED who have multi-agency needs. Implementation of a federal mandate requiring family driven care (FDC) within systems of care funded through the Children's Mental Health Initiative (CMHI) has revealed that most system of care leaders recognize the value of families as full partners in decision making at all levels of the system, strive to have meaningful family involvement, but are challenged by how to successfully engage families in this process. The purpose of this research study was to explicate more fully the roles of families by examining the structures, processes, and relationships characteristic of family involvement in system level service planning and delivery decisions within established system of care communities and to develop a framework that depicts how SOCs engage families in system level decision making. A qualitative secondary analysis (QSA) was conducted, using data collected through Case Studies of System Implementation, a five-year research study that used a multi-site embedded case study design to examine system of care development. Six well-functioning SOCs throughout the country participated in the original study. Team-based data collection from these sites included 307 system documents (e.g., state- and local-level reports; evaluation, grant and budget information; organizational charts), direct observations (41), and semi-structured interviews with key stakeholders (209), as well as stakeholder completion of 113 ratings exercises related to factors critical to system development and implementation. Interviews were conducted with policy makers, administrators, judges, service managers, direct care staff, families, and youth (>18) across all partner agencies within the SOC. Findings from the original study revealed not only information on system development but an emerging theme of the important role of families in planning and implementing the SOC. A team-based QSA was conducted to more thoroughly examine how families are engaged in system level decision making. Findings reveal the necessity of an engaged, locally developed, autonomous family organization that is regarded as an equal system partner, and at least one system of care leader who promotes FDC. Also present are collaborative activities such as training and coaching, evaluation, and grant writing; and family organization activities such as capacity building of families and strategic outreach to system partners. The SOCs also demonstrate specific relationship-building activities and exhibit a shared value of FDC throughout the system. A framework was developed to depict implementation of FDC based on study findings. The framework was then modified based on data collected during focus groups conducted with Lead Family Contacts, Principal Investigators, and Project Directors from system of care communities currently funded through the CMHI. Research results yield specific structures, processes, relationships, and a foundational shared value for FDC that are present in systems of care that engage families as partners in system level decision making.

La presente investigación menciona que desde que el Estado Peruano entró en emergencia sanitaria generó un cambio dentro de las rutinas diarias para la población peruana. Este cambio repentino afectó la salud mental de los niños y niñas menores de 11 años y he tornado en cuenta para mi estudio la población de habitantes de Lima Metropolitano, por consiguiente, el Ministerio de Salud (MINSA) por cuidar la salud mental de los niños y niñas, genero la aprobación de la Resolución Ministerial N° 180-2020-MINSA que lo presentó como "Guía Técnica para el cuidado de la Salud Mental de la Población Afectada, Familias y Comunidad, en el contexto del COVID.19" durante el mes de abril del 2020, donde menciona sobre el cuidado y autocuidado para la salud mental. Sin embargo, la guía técnica es un material que carece de diseño de información, como infografía digital. En consecuencia, al problema del diseño de información o infografía digital, se planteó como diversidad de soluciones, pero solo una propuesta cumplía con todos los requisitos del objetivo principal del proyecto, que es el material como herramienta practica que ayude a las madres a cuidar a sus hijos desde casa, sin la necesidad de buscar la consultoría a un personal de salud. Al final, el material que más se acomodaba a esas necesidades fue la infografía digital porque si cumplía con los objetivos del proyecto, además el proyecto se propone la creación de este nuevo material sea utilizado no solo para las madres de familia, sino que también pueda ser utilizado por diferentes personas que tengan a cargo el cuidar a un niño(a). / The present investigation mentions that since the Peruvian State entered a health emergency, it generated a change in the daily routines for the Peruvian population. This sudden change affected the mental health of children under 11 years of age and I have taken into account for my study the population of inhabitants of Metropolitan Lima, therefore, the Ministry of Health (MINSA) for taking care of the mental health of children and girls, generated the approval of Ministerial Resolution No. 180-2020-MINSA that presented it as "Technical Guide for the care of Mental Health of the Affected Population, Families and Community, in the context of COVID.19" during the month of April 2020, where it mentions about care and self-care for mental health. However, the technical guide is a material that lacks information design, such as digital infographic. Consequently, the problem of information design or digital infographics was proposed as a diversity of solutions, but only one proposal met all the requirements of the main objective of the project, which is the material as a practical tool that helps mothers to care for children. your children from home, without the need to seek advice from a health staff. In the end, the material that best suited these needs was digital infographics because if it met the project objectives, the project also proposes the creation of this new material that is used not only for mothers of families, but also that it can be used by different people who are in charge of caring for a child. / Trabajo de Suficiencia Profesional