Your child is in crisis. He is exhibiting symptoms of a mental health emergency, and you know he needs treatment right away. We’re fortunate to have wonderful hospitals in Bexar County, including two dedicated to children, and self-standing emergency rooms on almost every corner. But is a local emergency room (ER) your best option? What other options do you have?
Our previous post introduced you to the Yes Waiver, the State sponsored program for children and adolescents (aged 3 – 18) with chronic mental health issues. The program provides an array of home and community-based services that assist Medicaid beneficiaries to successfully live in the community and avoid institutionalization.
For those caregivers that may want or need to seek out this service, the first step is to visit the Texas Department of State Health Service Yes Waiver’s page to see if your county participates in the program. If so, the next step is to click on the Find your Local Mental Health Authority; the local mental health authority in your county is the organization that handles the application process and facilitates the Yes Waiver program. The Bexar County Mental Health Authority is The Center for Health Care Services and we spoke with Randa Gipson, the Contract Compliance and Operations Manager for the Yes Waiver Program, to get further details.
Topics: Crisis Intervention
Teresa was a lively child. She liked to play with her dolls and make up adventurous stories to share with her family. However, by the time Teresa was five, her happy disposition changed. Her mother died and the sudden loss was a severe blow to the young child. Now Teresa was anxious and depressed. She became a target of bullying in school and oftentimes cried in silence. Going to school became more and more difficult. Teresa became withdrawn and, over the years, her irrational behavior caused her father great concern.
What happens next depends on when Teresa was born.
Had Teresa been born in the early 1900s, she may have been placed in a state psychiatric hospital. For Teresa and others like her, institutionalized care increased access to mental health services. The state hospital model was based on the concept that patients lived in the hospitals and were treated by professional staff, relieving families who lacked the financial resources and medical knowledge to provide proper care for relatives. By 1900, the U.S. government had funded the building of 32 state psychiatric hospitals.
This institutional model increased care. However, in effect, the state hospitals were often underfunded and understaffed. By the mid-1950s, the U.S. government deinstitutionalized mental health services and, in return, states promised to provide community-oriented care as the new model. But this effort, too, was—and has been—underfunded.
According to the Treatment Advocacy Center, in 1950, before the state hospital closures, there were 560,000 beds for patients needing psychiatric treatment. But in 2010, there were only 43,318 beds available – the same number that was available in 1850 per capita before the state hospitals were built.
Today, there are fewer psychiatric beds in our nation for crisis care than in the 1950s. Take a minute to let that sink in.
A larger population.
The state hospitals were closed but the promised community mental healthcare facilities were never built. Instead, individuals challenged with mental illness began showing up in emergency rooms and prison cells—neither of which are equipped to treat mental illness.
So if Teresa was born in the early 2000s, she and her family may feel they have nowhere to turn. Teresa’s struggle with mental illness may be left untreated. At some point, she may drop out of school or experiment with substance abuse.
Teresa’s story is not unusual. Approximately one-half of all mental illnesses begin by age 14. One in five children suffer from mental illness, and of those, only 20 percent receive treatment.
What’s more, an overwhelming majority of Texas counties are designated as Mental Health Professional Shortage Areas, communities without a sufficient number of mental health care workers. Clearly, there is an opportunity for Texans to improve the way we care for children with mental illness.
Initiatives such as the One in Five Minds Campaign strive to raise awareness about mental illness, encourage advocacy on behalf of children, and to break down stigma so that more children get help. And initiatives like the Texas State of Mind Campaign propose a mental healthcare model in which children receive treatment through their family doctor, school or community.
If you’re not happy about the landscape of the current mental healthcare system, what can you do? Be an advocate. Learn more, share your story and speak up. And that’s just for starters.