Serious Emotional Disturbance (SED) for MH funded services

AGE: 0 years of age through 17 years of age

Individuals determined on the basis of a mental health assessment to have a serious emotional disturbance and display serious cognitive, emotional, and behavioral dysfunctions.

Must meet I + (II or III):

I.  Diagnoses Criteria:

One of the following DSM-IV-TR diagnoses which is the focus of the treatment being provided:

  • Attention Deficit/Hyperactivity Disorders (314.00, 314.01, 314.9)
  • Schizophrenia (295.xx)
  • Schizophreniform Disorder (295.4)
  • Schizo-Affective Disorder (295.7)
  • Delusional Disorder (297.1)
  • Shared Psychotic Disorder (297.3)
  • Brief Psychotic Disorder (298.8)
  • Psychotic Disorder NOS (298.9)
  • Bipolar Disorders (296.0x, 296.4x, 296.5x, 296.6x, 296.7, 296.80, 296.89, 296.90)
  • Cyclothymic Disorder (301.13)
  • Major Depression (296.2x, 296.3x)
  • Panic Disorder with or without Agoraphobia (300.01, 300.21)
  • Obsessive-Compulsive Disorder (300.30)
  • Anorexia Nervosa (307.1)
  • Bulimia Nervosa (307.51)
  • Post Traumatic Stress Disorder (309.81)
  • Intermittent Explosive Disorder (312.34)
  • Tourette's Disorder (307.23)

II. Treatment History (Treatment history covers the client's lifetime treatment and is restricted to treatment for a DSM-IV-TR diagnosis specified in Section I.)

The youth must meet at least ONE of the criteria below:

  1. Continuous treatment of 6 months or more in one, or a combination of, the following: inpatient treatment; day treatment; or partial hospitalization.
  2. Six months continuous residence in a residential treatment center.
  3. Two or more admissions of any duration to inpatient treatment, day treatment, partial hospitalization or residential treatment programming within a 12 month period.
  4. A history of using the following outpatient services over a 1 year period, either continuously or intermittently: psychotropic medication management, case management or SASS/intensive community based services.
  5. Previous treatment in an outpatient modality and a history of at least one mental health psychiatric hospitalization.

III. Functional Criteria

(Functional criteria has been purposely narrowed to descriptors of the most serious levels of functional impairment and are not intended to reflect the full range of possible impairments.)

The youth must meet criteria for functional impairment in two of the following areas. The functional impairment must: 1) be the result of the mental health problems for which the child is or will be receiving care; and 2) expected to persist in the absence of treatment.

  1. Functioning in self care - Impairment in age-appropriate self care skills is manifested by a person's consistent inability to take care of personal grooming, hygiene, clothes and meeting of nutritional needs.
  2. Functioning in community - Impairment in community functioning is manifested by a consistent lack of age appropriate behavioral controls, decision-making, judgment and value systems which results in potential involvement of the juvenile justice system.
  3. Functioning in social relationships - Impairment of social relationships is manifested by the consistent inability to develop and maintain satisfactory relationships with peers and adults.
  4. Functioning in the family - Impairment in family functioning is manifested by a pattern of: 1) disregard for safety and welfare of self or others, e.g., fire setting, serious and chronic destructiveness; 2) significantly disruptive behavior exemplified by repeated and/or unprovoked violence to siblings and/or parents; or 3) inability to conform to reasonable limitations and expectations. The degree of impairment requires intensive (i.e. beyond age appropriate) supervision by parent/caregiver and may result in removal from the family or its equivalent.
  5. Functioning at school - Impairment in functioning at school is manifested by the inability to pursue educational goals in a normal time frame - e.g. consistently failing grades, repeated truancy, expulsion, property damage or violence towards others that cannot be remediated by a classroom setting (whether traditional or specialized).