When three of the five grandchildren she is raising began to have behavioral problems, Erma Johnson did not have to look far for help.

	Bill Wade, Post-Gazette Erma Johnson, right, sits with Tyree Jamison, 9, one of three grandchildren who receive support services from Community Connnections for Families. Deborlyne Pamplin, left, is the famly's service coordinator. They are in her office at Addison Terrace in the Hill District, near Johnson's home. Click photo for larger image.

Community Connections for Families, a local program that aids children with serious emotional disturbances and their families, has an office at Addison Terrace, the Hill District public housing complex where she lives.

The program helped her get medical assessments and treatment for her grandsons, now 14, 12 and 9, as well as temporary help with clothing. It also taught her how to work with school officials and the social service system to help meet her grandsons' needs.

"If it had not been for this program, I wouldn't have known where to go," said Johnson, 64, who has had two open heart surgeries.

The program, developed by the Allegheny County Department of Human Services, is in its seventh year and has served nearly 400 children 6 to 14 years old. Currently, nearly 130 children are being served in the Hill District, East End neighborhoods, McKeesport, Sto-Rox School District and Wilkinsburg.

Funded initially by a $5 million federal grant, Community Connections now operates with local and state funds and Medicaid. Officials are hoping to expand it to other communities.

In Sto-Rox and Wilkinsburg, county officials also have implemented a similar program for young people 14 to 21. It now has 19 and has had about 29 participants since March.

A federal review of Community Connections late last year noted that it stands out among similar programs around the nation.

The reviewers found that children in the program were doing better in school, with fewer detentions, out-of-school suspensions and absences, despite the fact that many had serious health or behavioral problems.

Two out of three children enrolled last year had more than one mental health diagnosis; four out of 10 had been arrested prior to enrolling. Also, 15 percent had been hospitalized for psychiatric problems, 14 percent had run away from home and 5 percent had attempted suicide.

A majority of the children came from low-income, single-parent households and had parents with mental illness or substance abuse problems.

"These are youngsters with some very serious challenges," said Gary Blau, a branch chief at the Center for Mental Health Services in the federal Substance Abuse and Mental Health Services Administration.

Many children with serious emotional disturbances are at risk for hospital stays or other types of long-term care, often at taxpayers' expense, he said.

With programs like Community Connections, "there's a much greater probability children can remain at home with their families," he said.

In 1993, Congress began providing funds to programs to help serve children with serious emotional disturbances right in their communities, Blau said. Since then, 96 programs, known as System of Care initiatives, have been developed in 48 states and two territories. Annual federal funding has grown from $4.9 million to $106 million.

Recent studies of two Ohio communities found that spending for mental health services was higher in a System of Care, but those expenses were largely offset by reduced involvement in the juvenile justice system.

Youths involved in a System of Care were 57 percent less likely to commit a serious crime. And those who had been in trouble with the law before were less likely to get in trouble again, said E. Michael Foster, lead author of the studies and a professor of health policy and administration at Penn State University.

In Allegheny County, families involved with Community Connections receive assistance from a team that includes a service coordinator, who works to ensure that families get appropriate services, and a family support specialist, usually the parent of a child with a disability who is familiar with negotiating the service system.

Families also have access to training on topics ranging from parenting skills to sexually transmitted diseases to the workings of the mental health, juvenile justice and child welfare systems.

The programs are located in a variety of neighborhood sites. Families play integral roles in shaping them, even taking part in the local teams that evaluate the initiatives. They help design surveys, conduct community forums to gather information and provide input on training opportunities.

When family members expressed concerns that children with mental illness were not always accepted by other children at school, the program developed It's All About U, an anti-stigma initiative. It has been used in several local elementary and middle schools and received national recognition among System of Care programs.

Officials believe the neighborhood offices and emphasis on family input have fueled participation. According to a Community Connections report last year, nearly half the program's referrals came from parents or other caregivers, about five times higher than the percentage nationwide.

"That's considered to be a coup in the communities we're in and with the populations we're serving," said Gwen White, the project's director.

A variety of factors, including lack of education or having a mental illness themselves, may make family members reluctant to come forward for help, said Deborlyne Pamplin, a service coordinator for Community Connections.

Pamplin, who works with Johnson and her grandsons, said they have clearly benefited from the program. The children have gained independence and have learned new ways to control their anger and express their feelings, she said.

And Johnson has "gained a lot of knowledge about her children's diagnoses," Pamplin said. "She knows how to talk to counselors. She knows what to ask the children's teachers."