Formal counseling is provided to children and youth to address issues related to disruption in the youth's functioning. A functional assessment (CAFAS) is conducted at initial intake and at termination to measure the level of impairment on different subscales. The use of cognitive-behavioral therapy, and trauma focused care allow youth to focus on developing skills that reduce delinquency behavior..  The mid-year average CAFAS score of 87.5% indicates that youth are responding to the clinical interventions, thus reducing the level of impairment in areas of mood, behavior toward others, and behaviors that impact academic success. Every youth over the age of 10 is assessed for risk of substance use or abuse with an approved tool - CRAFFT. Of the 87 youth assessed, 9 scored at a level that placed them at risk for substance use, and they were referred to community services. During the course of the first six months of the year, 11 youth were identified as being at risk of suicide and were referred to psychiatric services. Youth identified family stress as a major contributor to their depression of suicidal ideations.  Transportation remains a critical need in St. Mary's County, and in an effort to meet families where they are, TCYSB expanded services to 2 elementary schools in Lexington Park. Saturday sessions also grant access to youth who  otherwise may be unable to participate in programming. At year-end, there were 448 cases who had received both formal and informal counseling as individuals, groups and families. Of this number, 163 were identified as disconnected youth, or children impacted by family incarceration. A total of 138 families were engaged in counseling services. 96 youth were assessed for substance abuse in the second half of the year, and 17 scored at a level that required them to be referred to a substance abuse treatment program. Specific outreach to the population through increased phone calls and regular mailings resulted in an increase in the number of residents served. Saturday and extended hours in Leonardtown and at the Patuxent Woods were also contibutory factors. Some youth and families also reported that TCYSB's social media presence provided them with information on available services.

St. Mary's County Public Schools provide referrals and space for group counseling, reducing the barrier that transportation in a rural area presents. The Department of Juvenile Services provides referrals and space for individual and group counseling to adjudicated and pre-adjudicated youth. During the summer TCYSB partnered with the Committee for a Community Center in Lexington Park to facilitate a Community Mapping Project, hiring 32 youth and 4 supervisors to conduct surveys, the results of which would help inform the County Commissioners as to the services that are needed in the Center when it is built in 2022. Youth who were found to be at risk for substance abuse were referred to Walden Behavioral Health for treatment. The Housing Authority of St. Mary's County is a strong partner, and TCYSB provides supportive services (outreach and education) to low income families who receive housing assistance. TCYSB through an agreement with the Housing Authority expanded services to Patuxent Woods primarily to children affected by family incarceration. Another partner, the Youth and Young Adult Program of the Southern Maryland Workforce Development JobSource Program, referred youth for work site development opportunities. Youth worked as Youth Development Assistants and Peer Mentors. The Senior Citizens Employment Program referred seniors for employment training opportunities. Seniors assisted with the extensive telephone outreach to families. TCYSB worked with the St. Mary's County Health Department on an educational program for the prevention of use of nicotine products among youth. This resulted in a modification of intake to directly gather information on use of nicotine products, and the risk of second and third hand smoke to children and youth.

The use of Cognitive-Behavioral Therapy, and facilitation of Managing Emotions have an impact on the improvement of level of functioning as demonstrated through the CAFAS scores. The use of trauma-focused therapy has been effective in stabilizing 19 children of incarcerated parents. Community outreach to disconnected youth has led to referrals for counseling services to address some of the behavioral health issues that this population experiences. The move to electronic records has had a positive impact on clinicians' ability to complete treatment plans on time (by the 4th session), and to more accurately measure progress. Staff development in the areas of Mental Health First Aid, SBIRT (Screening, Brief Intervention, and Referral to Treatment), Advanced Mindfulness Training provided staff with additional tools for enhancing service delivery. Clinicians also introduced an additional assessment tool to better address ACES (Adverse Childhood Experiences) and the trauma with which clients were presenting. This has resulted in a reduction in suicidal ideations and greater success with engagement in counseling.

The shortage of mental health clinicians presents challenges, however TCYSB has developed relationships with graduate programs for its internship program as a training ground for entry level counselors.  With transportation being a major barrier to families accessing services, emphasis will be placed on community outreach and the provision of services at community locations.  TCYSB will be adding another component to outreach that includes youth development and Youth Peer Mentors to work specifically with the disconnected youth population. Enhancing the social media outreach with Ready4Life-SOMD will also facilitate sharing of information between youth and service providers. Increasing referrals to the program requires community outreach and education, and diversity in outreach will be increased: regular media, social media, phone calls, mailings, participation in community events, and increasing collaborative efforts with community partners.

Mental health, substance abuse screening, and interpersonal skill development for at least 51% of families affected by incarceration and disconnected youth

51% of the population to be served are youth and families affected by incarceration and disconnected youth, that live with the Great Mills and Lexington Park area. However, no youth or families that meet these criteria from other parts of the county will be turned away.