'Why did we have to go through such a nightmare?'

By BARBARA WALSH, Portland Press Herald Writer

Copyright © 2002 Blethen Maine Newspapers Inc.

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	Staff photo by John Ewing Parker Matheson, 6, endured trips to the emergency room and 10 days at a psychiatric hospital before he was diagnosed by a pediatrician who specializes in emotionally troubled children.
	CASTAWAY CHILDREN: Maine's Most Vulnerable Kids Follow this three-part series on the plight of Maine children with mental illness and get more information including where to find help, a glossary of terms and how to voice your opinion, To top of story

The two-hour rage had ended.

Her 6-year-old boy now sat limp in the back seat as Charly Haversat drove to the emergency room.

"Finally," she told herself as she headed to the Portland hospital, "we're going to get help for Parker."

Haversat knew something was wrong with her wiry, brown-haired boy. He'd rage for hours over small slights, smashing his head on the floor, hurling himself against the walls of their Freeport home.

She had tried to make an appointment for her son with a child psychiatrist, to place him in a crisis counseling program. But waiting lists were four months long.

This day, Parker had grabbed a pair of scissors and said: "I want to cut my knee to feel what it's like to die." Haversat's family doctor responded: Take Parker to Maine Medical Center's emergency room.

There Parker and his mom sat. They waited in the ER for 13 hours, over two days, only to be told the hospital couldn't help her son. Maine Med didn't have the resources to treat Parker. The psychiatric hospitals and crisis centers that could care for him were full.

A Maine Med psychiatrist who specializes in adult patients offered Haversat this remedy: Take Parker home and give him cocoa.

"You've got to be kidding," Haversat told her.

The hospital declined to comment about Parker's case, citing confidentiality concerns. They did explain that they have child psychiatrists available at the hospital during the week, but there is limited staff available on the weekends.

Finding treatment for mentally ill children is not easy in Maine, and is especially difficult for children who are under 13.

Only 10 of the state's 41 crisis beds and 48 of the 122 psychiatric hospital beds are designated for younger children. There also are fewer services and treatment beds for children who are not yet teen-agers.

Before Parker received the care he needed, his family spent months searching for help. They waded through a fragmented and confusing mental-health system that offered little more than waiting lists and professionals unsure how to treat the 6-year-old.

"There's very little for them," says Dr. Harry Grimmitz, president of Maine's chapter of the American College of Emergency Room Physicians. "For kids under 12, there's only three psychiatric hospitals that have beds for them. When these kids end up in crisis, there's nowhere to put them."

Parker's rages began in the summer of 2001.

They intensified after his grandfather died in July.

"You couldn't restrain him," Haversat says. "He kept hitting his head against the floor, walls for 45 minutes."

"We knew these weren't just tantrums," says his father, Jack Matheson. "We were in uncharted territory and we didn't know what to do."

The family doctor advised them to call a psychiatrist, and Haversat called nearly two dozen listed in the Yellow Pages.

"Most of them didn't see kids, and the ones who did weren't available for four and five months," she said. "So we had nothing."

Like most other states, Maine is woefully short of child psychiatrists, with only 50 statewide.

Haversat phoned the state's crisis hotline for children. She was referred to Sweetser Family Services in Saco, a state-funded agency that treats and counsels children and families in crisis. Sweetser told Haversat it could evaluate Parker in two months.

Haversat made the appointment, hoping Parker wouldn't hurt himself or anyone else while they waited.

Two days later, on July 14, the boy said he wanted his sister's English muffin instead of his own. "It got to the point he was yelling, screaming, throwing things."

When Parker picked up the scissors and threatened to kill himself, his mother put him in the car and headed to Maine Medical Center's emergency room.

They arrived at the Portland hospital at 11 a.m. Parker frantically touched the chairs, the walls. Haversat waited patiently believing that finally someone would treat her son.

"I felt like we were finally going to get to the bottom of this. These people are going to help us," she recalls.

Eventually, an intern checked Parker's heart rate and blood pressure. A state mental health crisis worker arrived a few hours later and talked with Parker. The worker told Haversat that the state's crisis beds for children were full and no child psychiatrist was available.

"He said, 'Go back home, and if Parker gets worse, come back and we'll admit him,' " Haversat says.

Around dinner time, Haversat took her son home.

"We sat in the emergency room nine hours and got nothing," she says.

The next day, Parker wailed as his mother tried to get him to bed.

"He wanted to play a game and when I said 'no' he lost it," she says. "He started hitting his head against his bed board."

Parker cried over and over: "I need to understand. I need to understand."

Haversat carried her son to the car and drove back to the emergency room. Along the way, she called the hospital so a nurse could hear her son sobbing, yelling: "I need to understand."

They arrived at the ER close to 9 p.m. and sat in a room next to a psychiatrist's office.

Three hours later, just after midnight, Haversat says a psychiatrist who treats adults told her there was no help available - no crisis beds, no child psychiatrist on duty.

When the psychiatrist suggested giving Parker hot chocolate to calm him, Haversat asked the woman if she had any children. The doctor said she did.

"Would you want your kids treated this way?" Haversat asked.

The psychiatrist didn't answer. She suggested Haversat make an appointment with a social worker at the hospital's outpatient psychiatric clinic.

The hospital sometimes has interns available who are child psychiatrists - but not on this night. The hospital declined to talk about Parker's case or the psychiatrist's comments, citing patient confidentiality laws.

Two days later, the family took Parker to a clinic run by Spring Harbor, a South Portland psychiatric hospital. Parker erupted again during the visit, upset because he didn't like his sandwich. He slammed his head on the floor. He threw himself against the wall.

Parker flailed as his dad tried to restrain him. He raged for an hour.

The clinic's social worker asked the family: "How have you been dealing with this?"

She told the family Parker needed immediate help and arranged to have him admitted to Spring Harbor. It was dinner time when Haversat hugged her son and left him on the locked psychiatric ward at the hospital.

Haversat walked off the ward and heard the door slam shut behind her. She went to her car and sobbed.

"I had to leave my baby there," she says. "I was crying so hard I thought I was going to have a nervous breakdown."

Parker spent 10 days at Spring Harbor, where a psychiatrist put him on an antidepressant and anti-psychotic drugs to help him sleep and calm him.

The drugs eased his outbursts but also changed him, Haversat says. "It almost seemed like he was gone. Like he wasn't there anymore."

Parker told the doctors he understood why he was hospitalized: "Because I get mad, and I get sad, and really bad sometimes."

Parker also told a psychiatrist his dad hurt him and his mother didn't love him. The doctor warned the family she was referring them to the Department of Human Services.

"Here we are trying to get help for him, and we get referred to DHS," Matheson says.

Matheson explained to doctors that he restrained his son when Parker tried to hurt himself. "I would hold onto him, but he'd flail," Matheson says. "He'd struggle so much you could see the veins in his neck."

DHS later said they didn't have any evidence to substantiate abuse, Haversat says, and the state referred the case to Youth Alternatives, a private agency that offers parents advice and training in handling difficult children.

Matheson and his wife declined Youth Alternatives' services and contacted an attorney. The DHS complaint demoralized and frightened the family.

"I hit an all-time low," Havesat says.

On July 27, Parker was discharged from Spring Harbor with a possible anxiety disorder diagnosis, and the family again struggled to find a child psychiatrist willing to see their son. Haversat called dozens of state and privately funded agencies, searched the Internet, looking for programs and therapists to evaluate Parker.

She spent months deciphering a fragmented mental health care system that offered little direction. "It was exasperating," Haversat says.

In November, their family doctor suggested they go to Dr. Jack Mann, a Portland pediatrician who specializes in emotionally troubled children. Mann diagnosed Parker with attention deficit hyperactivity disorder, a neurological illness. Parker's parents learned that children with ADHD tend to have short attention spans, distract easily, dread change and act impulsively.

If Parker had received treatment instead of languishing on waiting lists, it's likely the boy would not have needed psychiatric hospitalization or the trips to the ER, Mann says.

"The key to treating these kids is early identification," says Mann. "If we wait until a child is suicidal or severely depressed, we've waited too long. But unfortunately, Parker's story, where people struggle with our terrible system, is common."

Four months after Mann treated Parker, Haversat and her husband gather in the living room of their Freeport home. Parker kneels on the floor with his mom, playing Chinese checkers. His dad rests in a nearby chair.

As Haversat talks about Parker's trips to the ER and the psychiatric hospital, Parker leans into her lap and she rubs his back. He wraps his arms around his mother and kisses her cheek.

"Parker doesn't talk much about last summer," his mother says.

Parker now takes Adderall, a medication that helps keep him focused and calm.

Much of the time, he is like any other boy. He collects stacks of Pokemon cards. He likes spiders and books about the mischievous monkey called Curious George.

On this winter afternoon, the sun colors the sky crimson as it sinks beyond fir trees in the family's backyard. As their living-room darkens, Haversat and her husband talk about their experience with Maine's mental health system. "Why did we have to go through such a nightmare?" Haversat asks.

"There's no triage for these kids," Matheson says.

Parker stares at his mom's hazel eyes, and she hugs her child. She is quiet and focuses on his face before speaking.

"If I had taken my son to the hospital for a broken arm, would we have waited 13 hours over two days to get help?" she asks. "Would someone have told us to go home and give him cocoa?"

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