Thursday, November 20, 2008

Children's mental health care lags in USA

From USA Today:

Publicly funded mental health care for children has improved in the past 25 years, but top officials in more than one out of five states say no child with serious mental disorders receives good care in their states, a report says today.

The report "gives us reason to be extremely concerned about children's mental health," says Michael Hogan, commissioner of the New York State Office of Mental Health.

The report surveyed state and county mental health officials and others involved with children's care. The National Center for Children in Poverty at Columbia University collected the information, updating a similar survey 25 years ago. Most children treated in public mental health programs are poor or in foster care, says Janice Cooper, who led the study.

On the positive side, many states now help support school-based mental health programs, which can stop trouble early, and a growing number promote or require treatment that's supported by evidence, Cooper says. But the school programs are spotty, she adds, and most states still don't spell out the care that has been proven to work for specific mental health problems.

Only seven states reported consistent funding for children of all ages. Also, some federal and state policies block Medicaid reimbursement for preventive or early care, such as with troubled preschoolers or those who don't have a major mental illness.

Among states reporting the best-quality public mental health care for children: Washington, Ohio, New York, Vermont and Maine.

Judging by experiences of parents, the report "seems too rosy," says Darcy Gruttadaro, children's issues director at the National Alliance on Mental Illness. "A lot of them have programs, but they often have long waiting lists too, so families just can't get good care for their kids."

The nation's struggling economy will send more children onto the public mental health rolls while cutting government budgets to support their care, Cooper predicts.

More money should be spent where the evidence shows it will have the biggest payoff: in prevention and early care, says Hogan, who favors boosting mental health services at pediatricians' offices and at day care.

"We know what to do," he says. "Our failure to address these problems early is costing us time, it's costing us money, and, frankly, it's costing us children's lives."