Research reveal, Part II - Professionals

Our article from April 6 shared compelling information from a recent survey that parents in our community don’t know where to turn when their child struggles with a mental health issue.  Many said that they would visit a local ER, not knowing that the vast majority of ERs in our community don’t offer psychiatric services. As a result an estimated 1,300 children have been boarded for hours without care.  This week, we share the results of medical professionals and their thoughts on mental health services in our community.

The results of the survey echo the thoughts of Dr. Fernando Guerra, who recently retired as a pediatrician, and was the former Director of Health for  the San Metropolitan Health District.  Dr. Guerra, an active public health consultant shared, “children are experiencing mental health crises every day in this city, yet there are not enough resources to meet their needs. We are failing our children.” 

The December 2014 survey results from 300 local health care professionals, conducted in partnership with an experienced research agency, revealed that access to mental health services is a significant problem. In fact, 89% of health care professionals reported access as a problem, with frequent comments like, “I am told no beds are [sic] available.”

Another survey question asked about the types of barriers experienced when trying to access mental health treatment. Two-thirds of professionals mentioned insurance coverage, stigma, and lack of providers as problem areas. One of the respondents wrote, “Medicaid or private insurance limitations [are an issue].” Another professional shared, “Long waiting times, confusing and complicated health care system, lack of coordination amongst providers, lack of effective data systems amongst providers, need to repeat their stories multiple times, multiple requirements and demands from different systems.” This comment, which outlines one significant barrier after another, provides insight into the immense difficulties faced in mental health care. Can you imagine if that were your child needing help?

Not surprisingly, parents and professionals who seek help face a “very long – months – wait to be seen as a new patient – not so helpful when a person is in crisis.”  Everyone involved in the mental health system of care wants change.  98% of the survey respondents indicated that changes are needed, and suggested an increase in outpatient services (80%), a regional psychiatric emergency service (67%), and 45% want to increase the number of inpatient beds available for crisis.

There are encouraging projects and collaborations on the horizon to mitigate this intense frustration.

One such collaboration is the Bexar County Mental Health Consortium, created by the leadership of the newly formed Bexar County Mental Health Department. This group is charged with improving the system of care coordination so that professionals and parents find the right help at the right time. Through the work of three committees, they seek to document crisis, sick and preventive mental health care options for children, adolescents, adults and seniors.  From there, they will also identify gaps and prioritize funding and resources to close those gaps.  Documenting the system of care is due for completion this summer. 

As shared in our last article, many funded projects to improve the delivery of mental health care are occurring throughout South Texas, via the 1115 Waiver.  Included in these projects are the recent Center for Healthcare Services crisis and respite center for children and adolescents, and plans by Clarity Child Guidance Center to expand services. Clarity Child Guidance Center is in the process of adding 14 acute care inpatient beds, and a six-bed psychiatric emergency service. These services are anticipated to be available in June of 2015. 

These important initiatives will help, but will not eliminate, capacity challenges in the short term, especially in outpatient services. We need to continue to attract psychiatry and psychology professionals to our city and to encourage young people to study in these fields. We also need to continue to advocate for better insurance coverage and funding overall. 

The struggle expressed by parents and professionals should be a wake-up call to our community. They speak for a much deeper crisis among the families in San Antonio.  We need to persistently ask our local, state or national policy leaders, “What is being done for children’s mental health?” Consider supporting one of our community’s nonprofit organizations who are addressing the needs of children dealing with mental illness. The effects of non-treatment are staggering - kids incarcerated, homelessness, high school dropouts, and, the agony of suicide. What are we doing to prevent tragedy?  Make no mistake, the “we” that needs to advocate, ask questions, and provide support, starts with YOU. What will you do now that you know the deep issues in our community?

Research Reveal, Part I - Parent's Focus