Cincinnati Teenagers Face Shortage of Mental Health Care Services

While "several thousand" Greater Cincinnati teenagers have "dual afflictions" of mental health and substance abuse problems, those children "run into service shortfalls," ranging from long waits, "overwhelmed" hospitals and "impossible to find" long term care, the Cincinnati Enquirer reports. Cincinnati's situation mirrors a nationwide problem, where 8,000 psychiatrists are available to care for children and adolescents with mental health needs, but 30,000 are needed. But compared with other cities about the same size, "Greater Cincinnati fares worse" in providing mental health care to mentally ill teenagers, the Enquirer reports. For example, Louisville, Ky., has 200 "safe beds" where teenagers can spend the night under professional care and Columbus, Ohio, has 180 such beds, but Cincinnati has only 90 safe beds. Furthermore, Cincinnati's state-run children's psychiatric hospital closed in 1995, and several other hospitals have either closed or cut back inpatient psychiatric units that once catered to young people. The bed shortage is the result of declining reimbursement and a "general re-evaluation of the benefits of institutional care," the Enquirer reports. At the same time, demand for child psychiatrists "far exceeds the supply of doctors," and psychiatric services at Cincinnati's Children's Hospital Medical Center has experienced a "tenfold increase in emergency visits since 1991," the Enquirer reports. Dr. Edward Muntel, president and CEO of NorthKey Community Care, said, "Inpatient services have dwindled over the years," mostly because insurers "won't pay for extended hospital stays." Insurers also have put "lifetime caps" on how many counseling sessions they will cover. As a result, previous month-long stays for detoxification and "in-depth counseling," for example, have turned into "short term ... stays and outpatient counseling." In addition, because intensive residential care "often is unavailable," Ohio teenagers and their families have gone "as far as Arizona" for treatment. Dr. Randy Sallee, director of Children's Hospital's psychiatric division, said, "I think [the lack of services] is unusual, given the wealth of community support for other children's issues. At least for [children with mental illness], we don't put our money where our mouth is" (Bonfield, Cincinnati Enquirer, 12/3).