With nearly 130 years of service to the community, Clarity Child Guidance Center has gained a considerable understanding of children’s mental health. We also understand the difficulties encountered by families and professionals when it comes to the dire shortage of mental health professionals, services, and resources in our community. We hear the stories, can feel the frustration, and see the pain etched on those who are affected.
Each year, we seek to deepen our understanding of the issues by partnering with an experienced research partner to survey both parents and professionals. The latest results confirm both our fears and our strategy to resolve community gaps. We will share the results of the parent’s survey first. In December 2014, 80% of parents surveyed reported that they did not know of any resources for a child in need of mental health treatment. Most reported “going to the ER” as their only option. Unfortunately, as one family discovered, the ER is not the most effective option:
“Jonathan was out of control. A simple discussion escalated to the point where he became so frustrated, he couldn’t speak. In a rage, he punched out a window, cutting his hand. As we tended to the cut, it was clear Jonathan couldn’t gain control of his emotions – the rage had subsided into a quiet, constant sobbing that signaled a deep despair. In a panic, we did the only thing we knew could help – we drove to a local ER. The nurse immediately asked Jonathan a series of questions related to his physical health, but nothing about his mental state. Minutes turned into hours. We waited for twelve hours. Jonathan slept fitfully as we waited for care. At some point, in sheer frustration, we began demanding care, only to be told that psychiatric care wasn’t available for kids at the ER. They were working to find space to admit him, but would ultimately be transferring him somewhere else for psychiatric care.”
Jonathan’s story isn’t unique. Over 1,300 children and adolescents each year are admitted to a local ER needing psychiatric care, only to discover it’s not available at that facility. Why has this happened? To understand, it’s important to learn the history. Pete Earley, a Pulitzer prize finalist, researched the history of mental health care and came to a profound discovery in his book, Crazy: A Father's Search Through America's Mental Health Madness. The public backlash against the inhumane treatment experienced in psychiatric facilities deemed “insane asylums” resulted in public policy that required states to invest in upgrading them. Unfortunately, for a period of 50 years, rather than investing in them, asylums were closed. The promise made by our legislators was to create community mental health facilities to provide proactive care so that asylums would not be needed. This promise was never fulfilled. Instead, we invested in expanding prisons, where many of the mentally ill now reside.
Clarity Child Guidance Center is intimately aware of the shortage of “acute services” in our community. In one 30-day period, 100 families contacted Clarity for care, yet every single bed in our 52-bed hospital was full. Finding resources within our community is difficult at best, and often impossible. Clarity Child Guidance Center is the only nonprofit in South Texas to provide this level of care to children as young as three.
However, encouraging news is on the horizon. One promising initiative is the Behavioral Health Learning Collaborative for Region 6 of the 1115 Waiver, or RHP6 Learning Collaborative. This group is made up of agencies, hospitals, and others invested in mental health services throughout central Texas. Most are receiving federal funding to increase capacity and services for mental health care. Under the leadership of the University Health System, this group is tasked with increasing access to care. The goals of RHP6 are to reduce ER admissions for patients struggling with mental illness, redirect them to appropriate care, and to contribute to documenting the system of care so that families and professionals have tools to navigate the system.
Local mental health agencies are also investing in capacity. The Center for Healthcare Services recently opened sixteen crisis and respite beds, and expanded their existing crisis line with an app available to download to a mobile device. Clarity Child Guidance Center is adding 20 more acute care beds. Six of these beds will provide a psychiatric emergency service for the South Texas region. Instead of children being boarded at ERs, where care is not readily available for psychiatric conditions, Clarity Child Guidance Center will be equipped to provide emergency service care.
Advances are being made and gaps are being addressed, but all of us need to continue to advocate in order to maintain and advance care. As a society, we sat idly by as mental health facilities closed, and are still closing – most recently in Alabama. Meanwhile, untreated children with mental illness are suffering the consequences – dropping out of high school, addiction, incarceration, and homelessness. More frightening, left untreated, people suffering from mental illness die on average 29 years earlier than their healthier counterparts. We are potentially faced with a generation of children whose futures are compromised. Our children deserve better. They deserve our care, and need us to advocate on their behalf. It’s not enough to read this editorial. Share it on social media. Talk about what you learned. Lend a helping hand and heart to those in need. Donate. Volunteer. Do something to counter years of abject neglect, because doing nothing has created what will one day be looked upon as one of America’s greatest failures.
Research Reveal, Part II – Professionals
Frederick W. Hines is president and CEO of Clarity Child Guidance Center, the only nonprofit treatment center in San Antonio and South Texas that specializes in children 3 to 17 who suffer from serious mental health problems.