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Children’s mental health needs still going unmet

Posted on June 3, 2010 by Staff

VICKI SMITH

Imagine being angry all the time but not having the words to express it or the experience to understand it. Imagine being raped or beaten by an adult who is supposed to love and take care of you. Imagine being so traumatized by being the victim of violence – or watching it happen to another – that flashbacks are as commonplace as computer games. Imagine hearing voices in your head that tell you to do things that will get you in trouble at school. Imagine being so sad that you don’t want to live into adulthood.

These are not imaginary stories. Sadly, hundreds of North Carolina children experience these feelings every day. Studies show that one out of every five children – sometimes as young as 6 – living in North Carolina has a mental illness. According to national studies, only around half of the children who need mental health services actually receive them.

In 2005, 58 percent of the children served were ages 12 to 17, 33 percent were ages 6 to 11 and 9 percent were under the age of 6. Their childhoods are traumatic. The symptoms of their illnesses are painful and severe. When untreated, mental health disorders lead to other problems – school failure, family conflicts, drug abuse, violence and suicide.

Even with treatment, children with mental illness are often excluded from the very support systems that should serve them. They cannot get along with their siblings. Their parents have difficulty coping with the symptoms of their child’s illness. This leads to a breakdown in the family system. Children with mental health needs who do not receive appropriate services continue to struggle. They cannot function in the classroom. They cannot develop normal, healthy relationships. They become a danger to themselves or others. And as a result, schools exclude them from the classroom, sometimes illegally. Children who are out of school place a strain on families that are already struggling to survive.

Here in the Tar Heel state, families are faced with a mental health service system that has been cut to the bone. While most children receive mental health services in a private residence (e.g., their home, a relative’s home), a significant number of children still receive services in out-of-home settings, including community residential homes, foster homes, correctional facilities (e.g., training schools), re-education programs (e.g., Whitaker School) and state psychiatric hospitals.

While the percentage of children treated in out-of-home residential treatment facilities has fallen nationally, statistics suggest North Carolina’s children are not experiencing the same trend. In recent years, the state more than quadrupled the number of locked residential placements (private residential treatment facilities) from 117 in 2005 to 494 in March 2010.

The state recently presented a plan that requires that community-based services be tried before a more restrictive out-of-home placement. This plan uses a model called the “System of Care,” which is built on the involvement of children and families, development of individualized treatment plans that meet the unique needs of each child and family and the coordination of services among multiple providers that coordinate services. Yet each of these provider systems is facing devastating budget cuts. The System of Care is a great model, but where are the funds to pay for the staff to implement it?

There is, of course, no denying the economic crisis that confronts the state, but cutting spending for mental health care for our children will only increase the pressure on an already strained system of care resulting in more costly outcomes for everyone. More cuts to the mental health system will be counterproductive because emergency room visits will increase and populations in detention centers, prisons and foster care will grow. North Carolina has both a legal and moral obligation to provide the basic needs to the most fragile children among us, children suffering with mental illness.
We must recommit to the positive mental health of North Carolina’s children. The state must develop a more balanced approach to the state’s financial crisis. By funding and implementing a comprehensive set of services and supports, care coordination, early intervention, robust transitions and supports in the least -restrictive environments that engage youth and their families, the state will spend less in the long run.

Vicki Smith is the executive director of Disability Rights North Carolina.

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