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Editorial: With mental health rewrite, once again devil is in details

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Friday, August 7, 2009

(Updated 3:00 am)

The General Assembly's decision to eliminate funding for group homes serving potentially violent children could backfire without assurances of adequate alternative care elsewhere. In its place comes another new initiative emphasizing high-intensity therapeutic foster care, or for some kids, a return home. Others could end up in community psychiatric centers.

But, as usual, the details are sadly lacking. Legislative committees have until Oct. 1 to come up with a new placement plan. Their only guideline apparently is to reduce out-of-home assignments.

And that might be a move in the wrong direction. Group home supporters make a reasonable case for not tampering with what they say is an effective care option for kids who can pose a danger to themselves or others.

Sending them back to a dysfunctional home environment may not be in their families', their neighbors' or their own best interests. Some cope with substance abuse problems or already have had run-ins with the law. They can need intensive counseling.

Unfortunately, the state's past efforts at mental health reform have turned out to be steps backward. A 2001 rewrite that switched the focus from treatment in state hospitals to community-based care proved to be outrageously expensive, poorly coordinated and plagued by lax oversight.

A further complication is this year's funding crunch, which has resulted in draconian mental health budget cuts that will prevent people desperately needing help, particularly in rural areas, from getting it.

What is best for the child should be paramount. Yet that's trumped by "what works somewhere else" and a rush to trim costs. As the state's dismal record confirms, too often changes are made in the mental health delivery system with little forethought.

Repeating those egregious mistakes ill serves clients or taxpayers.

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left-wing conspiracy theorist

August 8, 2009 - 3:09 am EDT

As someone who works for a Mental Health agency serving our youth, I can say this: we can choose to pay now, or we can choose to pay later. But make no mistake, we WILL pay.

lgrimestriad

August 8, 2009 - 12:55 pm EDT

As a therapeutic foster parent specializing in teenage boys, I can tell you that the youth coming out of these group homes are much more difficult to parent and include in your family life. Most of the kids coming from this level of treatment are not going to work out in family homes. The level of violence that these kids bring into the home is more than I am willing to live with--been there done that. I had kids come into my home from group homes and ended up putting locks on my bedroom door so that I could lock my own son in to keep him safe during the foster kids outburst. I have replaced windows in their bedrooms, had furniture thrown out of the room, had furniture busted up, doors pulled off the hinges, been cussed at, had kids assault me and my husband and threaten my son. I realized that I would not remain in an abusive situation if it were my husband or my son--therefore I will not live in a situation of domestic violence brought in by someone else nor will I ask my child to live in a violent situation.

It is already difficult enough to find therapeutic foster homes for troubled youth. But, to ask us to knowingly take violent kids into our homes and deal with them is unreasonable. Many of the youth that come into my home have very troubled backgrounds and home situations as it is--not a safe place to return them. Most of the kids that are in these group homes have already received many months and/or years of intensive home therapy and attempts at lower level out of home care. They were not successful then, why do we expect them to be successful now?

I am very selective about the young men I will take into my home now. I have had very successful outcomes because I know that the youth are ready, willing and able to utilize the opportunities they are given. The other therapeutic foster parents I know are also very selective about the youth they will bring into their homes. Where are these young people going to be placed?

lgrimestriad

August 8, 2009 - 4:41 pm EDT

Another thought. About those community based psychiatric units--have you ever tried to get a teen admitted to one of those. Many times I have taken youth from my home (sometimes they are in the back of a police car they are so violent) and I have been told that they are not a threat to me or themselves! I have never, in all my years of fostering, been able to get a teen admitted. I don't know what the criteria will be for getting admitted once the kids from the groups homes are back in the community.

Closing these homes is a disaster waiting to happen. Families can't get their kids admitted to psychiatric care now. All of the juvenile justice beds are full. Therapeutic foster parents don't want them in their families until they have undergone the proper treatments. It will be interesting to see what these families and Department of Social Services will do with this influx.