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Wednesday, July 2, 2014

Children with mental illnesses struggle to find help as schools, hospital systems are decentralized | The Lens

Children with mental illnesses struggle to find help as schools, hospital systems are decentralized | The Lens:



Children with mental illnesses struggle to find help as schools, hospital systems are decentralized


New Orleans has become a case study in how children and families are affected by decentralization of public education and mental health systems. The problem is particularly urgent because more schoolchildren suffer from mental health issues here than in other parts of the country.

One New Orleans 15-year-old with explosive disorder felt abandoned after the only therapist she trusted left town. A 14-year-old diagnosed with bipolar disorder and schizophrenia, who became suicidal and threatened others, had to travel 300 miles to get admitted to a hospital. A 6-year-old with attention-deficit hyperactivity disorder was told he couldn’t come back to his public school until his mother found mental health care services for him.
In recent years, New Orleans has become a case study in how children and families are affected by rapid decentralization of public education and mental health systems.
In theory, the city’s families should have more options than ever when it comes to schools and mental health providers. But decentralization has wrought some unintended consequences, particularly for children with the most severe needs, whose needs aren’t always met by private operators.
The problem is particularly urgent in New Orleans, where more schoolchildren suffer from mental health issues than in other parts of the country.
A 2010 report by the Children’s Health Fund and Columbia University’s Mailman School of Public Health found that children displaced by Hurricane Katrina were 4.5 times more likely to have symptoms of a serious emotional disturbance than a group of demographically comparable children in a national survey.
Moreover, surveys of public school children in the city have found that between 40 and 60 percent qualify for trauma counseling, said Doug Walker, the clinical director at Mercy Family Center, which provides extensive mental health services for New Orleans children.
In New Orleans, decentralization of public services has affected children with mental health needs in three major ways.
First, Gov. Bobby Jindal has privatized or closed several hospitals, leading to an acute shortage of beds for children who require overnight stays for mental health crises. At the same time, the state has widened the pool of low-income children who are eligible for community-based mental health care, as well as the number of private operators eligible to serve them. The result is a landscape where quality varies tremendously and turnover for operators and staff can be high.
Meanwhile, the independently operated charter schools that have opened since Hurricane Katrina have no central office to rely on for social and counseling services. Because they are judged almost solely on test scores, some schools have Children with mental illnesses struggle to find help as schools, hospital systems are decentralized | The Lens: