Lack of Community-Based Mental Health Care Keeps Many Children ‘Trapped’ in Psychiatric Hospitals, New York Times Reports

An "overall crisis" in mental health care has prevented thousands of children from being discharged from psychiatric hospitals and institutions into community-based treatment, the New York Times reports. These "stuck" children are ready for release, but cannot leave because of "the lack of outside treatment programs." This "widespread problem" is prompting lawsuits and indicates "yawning gaps" in treating children's mental illness. According to the federal Centers for Mental Health Services, about 60% to 70% of children who have mental disorders do not receive adequate treatment. However, the Times reports that "poor record keeping" and differences between states make it difficult to ascertain the actual number of children "trapped in the mental health system." Besides those who cannot be released from psychiatric hospitals, other children must wait for days, weeks or months in pediatric wards for room in a psychiatric ward or hospital. Other "wait-listed kids" must wait months for outpatient therapy or case management.

Many Factors Causes Problem
The Times reports that Massachusetts has about 100 "stuck" children at any given time. Marylou Sudders, the state's mental health commissioner, said the problem is caused by a "severe" staffing shortage, too few psychiatric wards and a "boomlet" in the state's adolescent population. Also, mental health advocates say managed care has "reduce[d] coverage" for mentally ill children, resulting in long waits for treatment. Sudders said most of the children "stuck" in psychiatric hospitals are usually "wards of the state," which "backs up the whole system" when they are not discharged in a timely manner. Nancy Rosenbloom, staff lawyer at the Legal Aid Society, said, "Children are really suffering. There are children at home getting no services; children in foster care not getting mental health services; children in the hospital who don't need to be in the hospital; and children in jails and prisons who are there because judges feel they need some kind of residential care." However, the Times reports there is "consensus" on the solution to the problem: more community-based treatment to allow patients to live at home.

Grants and Lawsuits
To foster programs that allow children to receive treatment for their mental illness while living at home, the Centers for Mental Health Services has been awarding "tens of millions" of dollars in grants. These programs attempt to coordinate care between different agencies instead of forcing a child to "negotiate a maze of agencies." The services save funds by "cutting hospitalizations and delinquency." To obtain such services, the Times reports many parents and advocates have filed class action lawsuits "demanding" such care. For example, in May a federal judge in Los Angeles ruled in favor of plaintiffs "demanding" coordinated services for more than 100 children. Also, litigation in New York on behalf of children in institutions is expected to begin "soon." In Massachusetts, a suit has been "brewing" as the state has been negotiating with patients' advocates, who "sent notice of their intent to sue a month ago," the Times reports (Goldberg, New York Times, 7/9).