FY23: For FY23, the MST-EA program was able to expand from a 2-therapist team to a 4-therapist team. When 1 of the original 2 therapists was promoted to team supervisor, 3 new team therapists were hired at the beginning of FY23. The new therapists completed their initial training in early FY23, and their caseloads were gradually increased as per model design. Also, while the average timeframe for serving a youth is typically 6 months, it is often longer for therapists new to the MST-EA model. For these reasons, the team did not reach its' target of serving 30 youth. Please see the performance measure Data Discussion for specific information related to each outcome.

Previous Narrative: 

The term “Disconnected youth” is used to describe youth and young adults between the ages of 16 and 24 who are neither working nor in school.  The data describing the status of the indicator for youth who are “disconnected” are from the Opportunity Index, which is designed to provide a snapshot of what opportunity looks like at the national, state, and county levels. The Index examines factors that support increased opportunity and economic mobility.  According to the Opportunity Index 2019, Baltimore County scored 56.3 out of 100 for a B-minus score. The estimated 9.8% of County youth and young adults between the ages of 16 and 24 who are neither in school nor working are reflected in the B-minus score.  The 9.8% represents an estimated 9,440 disconnected County youth and young adults.

The overarching Goal of the MST-EA program is to reduce the number of youth and young adults in Baltimore County that are disconnected from education and employment activities with a focus on youth and young adults with a serious diagnosed behavioral health disorder and extensive justice system and/or social service system involvement (e.g., youth exiting detention and youth aging out of foster care).

Research has indicated that youth and young adults involved with the justice system and/or social services system are at higher risk of experiencing behavioral health disorders.  Youth with behavioral health disorders are more likely to not complete high school and to be unemployed.  The Objective of the MST-EA program is to provide intensive, long term support for youth and young adults in their efforts to reach developmentally appropriate goals around such life domains as housing, education, employment, and treatment and management of their behavioral health disorder.

• MD Department of Juvenile Services
• Baltimore County Detention Center
• Baltimore County Court System
• Baltimore County Office of the Public Defender
• Baltimore County Department of Social Services
• Community Solutions, Inc.
• Prologue, Inc.

FY23: Successes: HFY1: With the beginning of FY23, the MST-EA team expanded to a full team with 4 therapists and a program director. In previous years, the team consisted of 2 therapists and a program director. The three new therapists on the team have completed their training and are gradually expanding their caseloads as per MST-EA protocol. Additionally, as a pilot program, the MST-EA team has begun to accept referrals from the Homeless Youth Outreach Services program. The first referral has been receiving services as of 12/22. 

Challenges: HFY1: Program referral numbers have been down during HFY1. The MST-EA program director recently visited with Department of Social Services (DSS) staff to orient new DSS staff to the program. Presentation generated 3 new referrals at the meeting. Director will continue this effort with other program referral sources.

MST-EA is a manualized treatment that is an adaptation of the evidence-based treatment, Multi-Systemic Therapy (MST). The program serves transition age youth and young adults, aged 17-24, with a serious, diagnosed behavioral health disorder (e.g., mood, anxiety, trauma, psychotic and/or substance use disorder).  MST-EA treatment targets are achieved by changing how clients function in their natural settings (home, school, community), leveraging the client’s strengths, pulling in positive supports, and developing the client’s skills and resources to overcome barriers to success.  Evidence-based interventions (e.g., cognitive behavioral therapy, behavioral interventions, motivational interviewing, affective education) are used to address treatment needs.

The MST-EA therapist collaborates with the client to design a treatment plan that can be implemented over a 6 to 8-month period.  Contact between therapist and client is frequent, sometimes daily (combination of in-person and phone sessions) with a minimum of about 4 hours of direct contact each week.  The therapists and supervisor work together to provide 24/7 availability allowing for flexibility in session scheduling and for emergency problem solving with clients and their social network. On average, clients participate in the program from 6 to 12 months. 

Clinical services are delivered in the client’s home, work, school, and/or neighborhood at times convenient to the client, with extensive effort devoted to engagement and retention of clients in treatment. The MST-EA therapist also works to secure and collaborate with the clients’ behavioral and somatic healthcare professionals to coordinate efforts around medication management and other healthcare issues.

MST-EA is designed to meet the needs of transition age youth and young adults, aged 17-24, with a serious, diagnosed behavioral health disorder (e.g., mood, anxiety, trauma, psychotic and/or substance use disorder) and extensive system involvement. This includes youth and young adults involved with the juvenile and/or adult justice system and/or the social services system (e.g., youth exiting detention, youth aging out of foster care, youth experiencing homelessness).

Improve outcomes for disconnected youth