Evaluation Efforts in Guam Help Lead to Improved Services for Children and Adolescents
Over the last 10 years, CFS’s Kathy Lazear has been a national evaluation consultant for two of Guam’s system of care initiatives through ICF International. Lazear has made five visits to Guam, conducting system of care assessments of the Federal Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Mental Health Services (CMHS) funded projects through a Comprehensive Community Mental Health Services for Children and Their Families Program grant. During the 3-day assessments, Lazear and a partner evaluator complete the assessments based on information obtained from system participant interviews, case record reviews, and additional documentation provided by grant community staff.
The first program, I Famagu’on-ta, a child-centered, family-focused system of care, delivers comprehensive, community-based mental health and related services through a wraparound process to children and adolescents with serious emotional disturbance and their families. The second program, Project Kariñu, was established because of a concern by parents and child care, and mental health providers about the increasing number of young children who were displaying signs of emotional disorders. Guam’s children and families experience significant risk factors for developing a serious behavioral health challenge; including 21 percent of children under the age of 5 live in poverty and significant numbers of children with developmental disabilities, experiencing maltreatment, children with adjustment and disruptive behaviors, and caregiver’s physical and mental health illnesses. The goal of Project Kariñu is to develop and implement a comprehensive early childhood system of care through a public health approach and system of care framework. Through the assessments, Lazear states that “Project Kariñu has clearly elevated the importance of identifying and addressing social-emotional needs among young children.”
Guam is an unincorporated island territory of the US and is the southernmost island in the Mariana Island chain. Located in the Western Pacific between Hawaii and the Philippines, Guam is the westernmost territory of the US.
“Working in Guam has been an enriching experience. Although the island of Guam consists of only about 220 square miles, with a total population of about 180,000 it is a multiethnic, culturally and linguistically diverse community. The indigenous Chamorro people are the largest ethnic group on the island, making up 37% of the population, followed by Filipinos, people from the Freely Associated States of Micronesia and Palau, White, Asian nationalities other than Filipino, and individuals reporting two or more ethnic origins. English and Chamorro are the official languages of Guam. While the most common language is English, 64% of the population speaks both English and another language in their homes, and 15% of the population speaks a primary language other than English in their homes," said Lazear.
Over the past 15 years, Guam’s population has seen significant immigration from the Pacific Island entities (i.e., the Republic of Palau, the Federated States of Micronesia, and the Republic of the Marshall Islands) as a result of the Compact of Free Association between the US and these Freely Associated States. Lazear observes that “increased immigration, while expanding the cultural and linguistic diversity of the community, has also placed significant demands on the island’s infrastructure and human services, including education, social welfare, public safety, and public health services.”
There are two major U.S. military bases on Guam with current active military population of 6,000; however, this number could increase dramatically as the US plans one of its largest realignments of military assets in decades, relocating Marines from Okinawa, Japan to Guam.
“The people of Guam are struggling to grasp its impact, including the significantly impact on the ethnic/cultural makeup of the island’s population.” says Lazear. “The planned military build-up is expected to bring thousands of people to Guam, changing the island in many ways. Any increase in the military population brings with it far-reaching implications for Guam’s economic, social, and environmental infrastructure and will place additional demands on the island’s community resources, including child and family services."