Reader, Have you heard the phrase "no wrong door" before?

A Google search didn't bring up a standard or formal definition, but the description I found that most aligns with my understanding of the concept is this:

"The vision for No Wrong Door is that every door in the region’s healthcare and human services system should be the right door with a range of services being accessible to everyone from multiple points of entry."

This is a lovely and logical idea in theory.

But I have come to question how well it works in practice.

I work closely with a school mental health collaborative in DC and at our meeting a couple weeks ago, one of the members shared with us results from an evaluation of DC's school behavioral health expansion. There were bright spots and progress to celebrate, but one thing that stood out to me in terms of challenges that remain was that about half of students reported still not knowing where to go for help in the school. We have heard our partners who lead parent advocacy in DC lament about this too - even parents who are deeply engaged in advocating for their children don’t know where to turn or what resources are available at their own schools. This is clearly not due to a lack of involvement on their part, so why is this happening?

Let me share a counterintuitive guess with you - I don’t think the problem is that there is nowhere for them to turn. I think the problem is there are too many places for them to turn.

This is a theme we heard repeatedly in community input gathering to inform the Fairfax Children's Behavioral Health Blueprint.

Imagine that you’re Kira - a mom with two elementary school aged kids, one of whom is in need of mental health supports. You reach out to various folks within the school and community for suggestions, and each person hands you a list of resources available for kids with mental health needs. There are so many resources that you’re overwhelmed about where to start and how to choose one. But you decide to just pick one at random and call them. Turns out they are no longer in business. You try another number. They don’t have any spots available. You move to the next number on the list. They do have availability starting next month but your income is too high for you to be eligible. The next place doesn’t have supports for the kind of mental health issue your child is struggling with. And on, and on, and on.

While the idea of "no wrong door" is great in theory, in practice, it often involves someone behind every door being equipped with a list of other places and people to point someone to. This would be fine if the lists were kept updated, limited to services that were currently available, categorized by eligibility, and tailored to specific needs - but they are rarely any of those things, much less all four.

What people most need is not a laundry list of generic resources that may or may not be available to or appropriate for them. What they need is a way to navigate to the right solution for them - whether that is by way of a person (like a navigator or case manager), an interactive database (imagine being Kira and having a website where you could type in your child’s age, their mental health needs, your family income, your insurance, etc. and receive a list of organizations that currently offer services that meet your specific needs and eligibility), or some other solution (Have an example or ideas? Email me!)

What people often need is one right door - someone or something to help them navigate through all that's available to find the right fit for them.

This is true for mental health support, for childcare, for any number of other needs people are seeking services for.

As anyone who’s ever been handed a laundry list of resources can vouch for, sometimes too many doors can actually leave us feeling lost. If we can shift more systems to create one right door, maybe we can connect far more people with the services and supports they need - not just in theory, but in reality.

Until next time,

Vinu

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