State Cutbacks Hinder Youth Access to Mental Health Services

Although the demand for mental health services for youths is growing at "unprecedented levels," cutbacks in several states have made it "more difficult than ever" to receive care, the AP/Worcester Telegram & Gazette reports. A report issued by the Surgeon General in 2000 found that approximately 11% of Americans between ages nine and 17, or about four million youths, suffer from "a major mental illness that results in significant impairments at home, at school and with peers." The rising demand may be linked to more awareness of mental issues and a "more stressful world" for youths, according to the AP/Telegram & Gazette. Despite the rise in diagnoses, several states, including Missouri, Nevada and South Carolina, have cut their mental health budgets, and others, such as California, plan to do the same. Congress is also considering cuts to mental health programs for youths. Some states, including New York, have refused to increase funding to such programs, according to Dr. Raul Silva, a child and adolescent psychologist with the New York University Child Study Center. There is also a nationwide shortage of psychiatrists and mental health workers trained to deal with youths, according to the AP/Telegram & Gazette. As a result, many youths in need of mental health care are waiting up to two months to receive help, the AP/Telegram & Gazette reports. Dr. Rob Garofalo, an adolescent health specialist at Children's Memorial Hospital in Chicago, said, "It's a crisis. It's reached epidemic proportions" (Irvine, AP/Worcester Telegram & Gazette, 6/19).

California Program in Jeopardy
A debate over who should pay for psychological care for 27,645 California youths with special education needs may jeopardize such care altogether, the Los Angeles Times reports. When the program, known as "3632" after the state Assembly bill that funded it, was established in 1984, 90% of its money came from a state fund for community mental health programs, and 10% came from the state's general fund. The community mental health fund was eliminated in 1991, and the state's general fund fully reimbursed the counties for such services for more than a decade. However, a recent audit by the state controller's office said that counties should pick up 90% of the program's funding, while counties insist that the state should continue to "foot the bill." The "spat" between the counties and the state has precluded the state from paying the counties for one year, the Times reports. Now mental health providers are saying they may have to cut services to the children if they can not be guaranteed reimbursement. In addition, providers suggest that the state could be "vulnerable" to lawsuits, because federal law mandates free mental health services for children with special education needs. A bill approved last week by the state Legislature would require the state's general fund to fund the program, but Gov. Gray Davis (D) has not yet taken a position on the bill, the Times reports. Meanwhile, mental health advocates last week lobbied and won approval from the Legislature budget conference committee to pay $60 million of the $95 million owed to providers, going back to last July (Pierson, Los Angeles Times, 6/19).

Nevada 'Gaps'
Gaps in Nevada's mental health system have precluded "thousands" of state residents from receiving care, according to a new report by the state Division of Mental Health and Developmental Services, the AP/Las Vegas Sun reports. The report estimates that 5.4% of Nevada's population, or about 83,000 people, suffers from "serious mental illness," and that about 25% of those people are homeless at any given time. The report suggests the state place "high priorities" on increasing the number of beds for the mentally ill, psychiatric emergency services and counseling, medication and services to the homeless. The state has not estimated how much the improvements would cost, but it provides information the DMHDS will use to develop its upcoming biennial budget, DMHDS Administrator Carlos Brandenburg said (AP/Las Vegas Sun, 6/18).

President's Commission To Meet This Week
C-SPAN's "Washington Journal" on June 19 features an interview with Michael Hogan, chair of the President's New Freedom Commission on Mental Health and director of the Ohio Department of Mental Health. The commission meets for the first time on June 19 in Washington, D.C., and has one year to conduct a "comprehensive" study of mental health service delivery in the United States and make recommendations for its improvement. According to Hogan, Bush cited three problems influencing access to mental health care when he created the commission: the stigma associated with mental illness, inadequate insurance coverage and a "fragmented" and "chaotic" mental health service system. Hogan said that many federal, state and local programs "are trying to do something helpful, but in a way they make the situation more complicated." Hogan said the commission will identify and highlight "oases of excellence" around the country and make "concrete recommendations for change" so that "more communities could take those kinds of positive steps." A video excerpt of Hogan's comments is available online in RealPlayer Video. The full segment of Hogan's interview will also be available online after the broadcast ("Washington Journal," C-SPAN, 6/19).