Rebuild system meant to treat mentally ill kids
Copyright © 2001 Blethen Maine Newspapers Inc.
Maine's mentally ill children are being severely neglected. As Barbara Walsh's heartbreaking series "Castaway Children" pointed out, Maine appears to be misspending its money and efforts to help these children.
The series told the stories of teenage boys and girls who are depressed to the point of suicide. Some are so ill they throw themselves against walls and beat their fists on their parents, who try desperately to restrain them.
The series told of children and parents spending hours, even days, in emergency rooms trying to get help, only to be sent home because there is no help: not enough psychiatric beds to take their kids, not enough child psychiatrists to see their kids, not enough money — or at least not enough money spent in the right way — to treat them early and close to home.
Parents have given custody of their children to the state they could qualify for federal assistance.
Either surrender your child to the state or let the child suffer indefinitely. Can any parent imagine a more horrible choice to be forced to make?
A society that creates that situation does not fit anyone's idea about what 21st-century America should be like. The stories were sad and depressing, but they also provoke frustration and anger. Time and again, mothers and fathers are putting in heroic efforts to literally, in some cases, save their children's lives, only to be met by a complex and strained system that would drive less dedicated parents to throw in the towel.
That's not the way the system is supposed to work in modern, civilized society.
We have long recognized that the state — all the people, banded together — has a social and legal obligation to care for those who are unable to care for themselves. That's why there is a state Department of Human Services, which has the responsibility for developing programs that should have been there to help these children and their families. But tragically, that has not happened; at least, it has not happened enough.
Often those who examine social and civic problems conclude that the key to a solution is spending more money. As Walsh made clear, that it not the situation in this case. The state has spent a lot of money, but not all of it seems to have been spent wisely.
Since 1997, Maine has sent 737 children out of state for psychiatric treatment — a number that astounds experts in the field.
As Walsh pointed out, the state spent $231 million last year on treatment for mentally ill children, but only 28 percent of that went to support children and families in their own homes. The state paid as much as $1,000 a day to treat these Maine children in facilities as far away as Georgia.
While there may be some rare exceptions, this costly approach to treatment is bad public policy and bad medicine. It is wrong for sick children, who need to be near loving families. It is wrong for families, who do not want to be split apart. It is wrong fiscally. The money could buy much more support closer to home.
It is so astoundingly wrong in so many ways that it is hard to imagine that those in charge did not act to end it long ago. The problem is not money; it is how the money is spent. And that comes down to leadership, understanding and empathy for the children and families who suffer.
In fairness, it cannot be said that state officials have done nothing. The number of children sent out of state has been falling. More money has been allocated for home-based treatment.
But Walsh made it painfully clear that far more must be done, and each day of delay takes a real and painful toll on too many children and parents whose only fault is being sick and wanting to get well. Each day also continues the process of putting money in the wrong places to truly solve the problem.
State officials — and those seeking election as future state officials — must take a fresh look at these issues and the heart-breaking stories of the real people involved. They should look past business-as-usual approaches and reinvent the system so it can succeed.
In a recent editorial, the Portland Press-Herald asked: If Maine were to design a mental health care system for children from scratch, would it devote nearly three our of every four dollars to crisis intervention rather than prevention? Would it decide to send these children to far-flung institutions hundreds and sometimes thousands of miles away? Would it create perverse incentives for parents to give up custody of their kids in order to receive "appropriate treatment"? The answer, of course, is no.
These questions, and others like them, should be a blueprint for everyone who professes to care about these children and their families, and everyone who wants state money spent wisely.
This system is broken — shattered, like the lives of too many children and their families. Children will continue to suffer — to be cast away — until it is fixed.