2003-09-01 -- Parents Must Surrender Children to Get Them Mental Health Treatment


This is what they call "family values" under capitalism:

New York Times, September 1, 2003

Mental Care Poor for Some Children in State Custody

By ROBERT PEAR

WASHINGTON, Aug. 31 - Thousands of parents have given up custody of
their children under pressure from states in order to obtain treatment
for the children's severe mental illnesses, federal investigators say,
but some states have not lived up to their end of the deal.

Federal officials said they had found deplorable conditions in many
state institutions where children were supposed to receive treatment.

For example, investigators from the civil rights division of the
Justice Department recently found "significant and wide-ranging
deficiencies in patient care" at Metropolitan State Hospital in
Norwalk, Calif., near Los Angeles. The hospital provides patients ages
11 to 17 with "woefully inadequate" treatment and unnecessary
medications, exposing them "to a significant risk of harm and to
actual harm," the department said.

Nora A. Romero, a spokeswoman for the California Department of Mental
Health, said the state disagreed with some of the findings but was
taking steps to improve care.

The Justice Department also said children with mental disorders had
been subjected to "unhealthy, inhumane and unlawful" conditions at two
state training schools in Mississippi. Federal officials said children
with mental disorders were not even supposed to be at the schools,
Columbia and Oakley.

The Mississippi Department of Human Services said it would work with
the state's Department of Mental Health to provide "alternative
placement" for children found to be mentally ill at the schools.

In a survey of state and local officials, the General Accounting
Office, an investigative arm of Congress, found that parents had
placed more than 12,700 children in the child welfare or juvenile
justice systems so the children could receive mental health services.

But those figures came from just 19 states, so the nationwide number
was probably much higher, said Cornelia M. Ashby of the accounting
office. The other 31 states did not respond to the survey or could not
provide any data, Ms. Ashby said.

In desperation, parents say, they have sent their children to foster
homes, state mental hospitals, juvenile jails and other institutions
where the children were supposed to receive treatment.

Cynthia Yonan of Glendale Heights, Ill., said local health officials
"directed me to turn my twin sons over to the state to secure
treatment" for bipolar disorder and other mental health problems.

Patricia Cooper of Fayetteville, Ark., said state officials had
suggested that she give up custody of her 12-year-old son so he could
get mental health care that was not available under her insurance
policy.

Senator Susan Collins, Republican of Maine, said, "Custody
relinquishment is a symptom of a much larger problem: the lack of
available, affordable mental health services for these children and
their families."

Representative Pete Stark of California, the senior Democrat on the
Ways and Means Subcommittee on Health, said he and Ms. Collins were
drafting legislation to halt "this barbaric practice."

The bill would offer $55 million in federal grants to states to
improve services for mentally ill children, so parents would not have
to give up custody.

Many states, facing the worst budget problems since World War II, have
cut Medicaid and mental health programs in the last two years.
Medicaid finances the care of many mentally ill children in state
custody.

A federal advisory commission appointed by President Bush recently
reported that the nation's mental health system was "in shambles." The
22-member panel, the President's New Freedom Commission on Mental
Health, expressed alarm at the practice of trading custody for care.

"When parents cede their rights in order to place their children in
foster care or in a program for delinquent youth, they may also be
inadvertently placing their children at risk for abuse or neglect,"
the commission said.

The commission said that 5 percent to 9 percent of all children in the
United States - at least four million - had serious emotional
disturbances. A survey by the National Alliance for the Mentally Ill,
an advocacy group, found that parents give up custody to get care for
about one-fifth of such children.

When states take custody of children, they are generally required to
provide medical care, including mental health services.

"Foster parents can get mental health services that the biological
parents could not get for their children," said Tammy Seltzer, who has
represented children as a lawyer at the Bazelon Center for Mental
Health Law in Washington.

Theresa A. Brown of Westbrook, Me., said she had been told by state
officials that her daughter, Heather, "would have to be in state
custody in order for her to get treatment for her behavioral and
emotional problems."

Since giving up custody, Ms. Brown said, "I'm no longer treated like a
parent." She said she was generally not consulted about her daughter's
treatment and had only limited visiting privileges.

Peter E. Walsh, acting commissioner of the Maine Department of Human
Services, said "we want to try to help" Ms. Brown. Part of the
problem, he said, is that "the federal government has never put up any
real money for children's mental health services." Maine, he said, is
trying to provide more services to children at home, so they can stay
with their families.

The accounting office said even parents with private health insurance
had difficulty paying for treatment of children with severe mental
disorders. "One outpatient therapy session can cost more than $100,"
Ms. Ashby said, "and residential treatment facilities, which provide
24 hours of care seven days a week, can cost $250,000 a year or more."

Private insurance plans usually set stricter limits on mental health
care than on treatment for physical illnesses like diabetes and
cancer.

Congress is considering legislation that would require insurers to
cover mental illness in the same way they cover a physical illness.
But insurers and employers have resisted the proposal, saying it would
increase costs.

Fourteen states have laws that prohibit child welfare officials from
insisting that parents surrender custody to get mental health services
for their children.

But such laws, by themselves, do not increase the supply of mental
health services. In some of those states, officials said, they can
still suggest that parents voluntarily give up custody.

The National Mental Health Association, an advocacy group in
Alexandria, Va., says 29 states have cut spending on mental health
care in the last year.

In Texas, mental health benefits in Medicaid and the Children's Health
Insurance Program have been significantly reduced. Michael M. Faenza,
president of the National Mental Health Association, said the Texas
cuts would "virtually eliminate mental health benefits" under the
Children's Health Insurance Program.

Ms. Seltzer said that if states provided more community mental health
services, parents would not have to relinquish custody and states
could save money.

Experience in New York, Vermont and Kansas shows that community care -
at home, in school and at community mental health centers - costs
about half as much as care provided in hospitals and other
institutions, Ms. Seltzer said.

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 Dallas-Fort Worth Star Telegram,  Mon, Sep. 01, 2003



'Training schools' mistreat children By David M. Halbfinger The New
York Times

COLUMBIA, Miss. - One Saturday morning not long ago, when Bill C.
drove 80 miles to the Columbia Training School to see his 15-year-old
daughter, locked up by the state of Mississippi for skipping school,
she held up her hands and showed him dozens of nicks and cuts. Staff
members had forced her to do scores of squat-thrusts on gravel, she
quietly told her father, and refused her even a Band-Aid for her
bloody hands.

"They said, 'You did it to yourself on purpose,' " she told her
father, who insisted that their names not be printed, out of fear of
reprisals against his daughter.

When Jason, 15, was ordered to the Oakley Training School in March
after a string of burglaries, he hoped to get treatment for his
bipolar disorder, which relatives say arose from sexual abuse he
suffered at age 3. But in letters to his father, Jason was soon
begging to be transferred to a state mental hospital.

Stories like these are among the mildest of the accounts now emerging
of life inside the Columbia and Oakley training schools, Mississippi's
two state-run institutions for boys and girls deemed juvenile
delinquents.

Established by federal law and state policy, the schools are supposed
to rehabilitate and treat children charged with misdeeds ranging from
mischief to homicide. But interviews with relatives of students, as
well as with one child released from Columbia, suggest otherwise.
Together with a 48-page report made public recently by investigators
from the U.S. Justice Department's civil rights division, they paint a
bleak picture of the schools as debilitating dumping grounds for
troubled children.

Woefully underfinanced, understaffed and ill-equipped, the schools and
their poorly trained workers dole out a volatile mix of physical and
verbal abuse and mandatory Bible study, but withhold basic medical
care and a decent education -- all in violation of state and federal
laws, according to the Justice Department's report.

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Houston Chronicle, August 30, 2003

Over 500,000 Texas children to lose health care benefits

Cuts likely will worsen state's record on insured kids

By TODD ACKERMAN Copyright 2003 Houston Chronicle

Maria Torres had no health insurance when Texas Children's Hospital
doctors told her that her 3-year-old son's most urgent concern wasn't
the ear infection she brought him in for, but a life-threatening heart
condition needing surgery as soon as possible.

Torres quickly signed up for the Children's Health Insurance Program,
or CHIP, the state-run federal program providing benefits to the
indigent.

A month later, it paid the bulk of her son's open-heart procedure and,
nearly two years later, the heart is functioning smoothly.

"It was a life-saver," said Torres, a single mother of three. "If it
wasn't for CHIP, I don't know what I would have done. It's the perfect
program for working parents."

But under a new rule, Torres' son would not have been able to receive
the surgery in time. The rule now requires a waiting period of 90 days
before a child can receive coverage.

The new rule is one of a number of sweeping changes to CHIP approved
by the 2003 Texas Legislature.

Beginning Monday, the more than 500,000 Texas children enrolled in the
program will lose dental, vision, hospice and most mental health
services. By 2005, 170,000 children will lose coverage completely.

The cuts will likely compound Texas' distinction as the worst in the
nation when it comes to percentage of uninsured children. With 22
percent of its children lacking health insurance from 1999 to 2001,
Texas ranked 50th among states, according to the 2003 Kids Count Data
Book.

"This is a huge step backward," said Barbara Best, health project
manager for Children's Defense Fund of Harris County. "Lots of states
have faced funding shortfalls, but none has made such drastic cuts as
Texas. It's particularly a shame because we made such a massive
outreach to educate people about the program and get them enrolled
since it began in May of 2000."

Best said the most frightening thing is that so many people still
don't know about the cuts. She told of a health care center
receptionist who was surprised when she mentioned them to her.

Many of those who knew about the cuts squeezed in last-minute
appointments before the coverage ended.

Theresa Pardo, a single mother employed full time and taking classes
at San Jacinto Community College, brought her 9-year-old daughter to
the dentist Thursday for a troublesome tooth, but worried about what
she'd do if it required follow-up treatment.

Her fears turned out to be groundless -- the tooth required a simple
extraction -- but Pardo still doesn't know what to do about the future
health care of her daughter, who regularly sees doctors for asthma and
vision problems. She's looking over different health care plans, but
hasn't found one she can afford.

"It's not like I have expenses I can cut," said Pardo. "I'm working
two jobs, living in an old apartment in an inexpensive area, trying to
be a good parent. It's like you can't win for losing."

All told in Harris County, 31,000 children will lose coverage
completely by 2005, and 92,000 children will lose certain benefits
today.

Of particular concern are cuts to children's mental health services.
Only minimal services now will be provided, including one outpatient
diagnostic visit, consultation after stabilization of an emergency and
six medication management visits per enrollment period. All other
inpatient and outpatient mental health services have been eliminated,
including counseling, rehabilitation, treatment and therapy after a
crisis.

Kathy Smith, a single mother of two, fretted about the effect of such
cuts on her 8-year-old son, who has a mild case of attention deficit
hyperactivity disorder. He made great progress the past two years,
thanks to group sessions that he attended weekly in which children
with ADHD learned how to socialize with each other. Now the cost will
be prohibitive.

"He's no longer having any behavioral problems and his behavior grades
in school went from C's and D's to B's and then to A's," said Smith.
"The sessions were great for helping him interact with other children.
I hope he doesn't slide back without it.

"It's all extremely frustrating, so much so that I'm almost in tears.
I'd just like to know where all the money we pay in taxes go, that we
have no money left to spent on taking care of our kids."