HELPING FAMILIES SECURE CARE FOR MENTALLY ILL CHILDREN

Serious mental illness afflicts millions of our nation's children and adolescents. It is estimated that as many as 20 percent of American children under the age of 17 suffer from a mental, emotional or behavioral illness. Of these, nearly half have a condition that produces a serious disability that impairs the child's ability to function in day-to-day activities. What is even more disturbing is the fact that two-thirds of all young people who need mental health treatment are not getting it.

Behind each of these statistics is a family that is struggling to do the best it can to help a son or daughter suffering from serious mental illness to be just like every other kid – to develop friendships, to do well in school, and to get along with their siblings and other family members. These children are almost always involved with more than one social service agency, including the mental health, special education, child welfare, and juvenile justice systems. Yet no one agency, at either the state or the federal level, is clearly responsible or accountable for helping these children.

Too many families in Maine and elsewhere have been forced to make wrenching decisions when they have been advised that the only way to get the care that their children so desperately need is to relinquish custody and place them in either the child welfare or juvenile justice system. Yet neither system is intended to serve children with serious mental illness. Child welfare systems are designed to protect children who have been abused or neglected. Juvenile justice systems are designed to rehabilitate children who have committed criminal or delinquent acts and to prevent such acts from occurring. While neither of these systems is equipped to care for a child with a serious mental illness, in far too many cases, there is nowhere else for the family to turn.

Earlier this year, the General Accounting Office (GAO) completed a report that I commissioned looking into this issue. The GAO surveyed state child welfare directors in every state, as well as juvenile justice officials in the 33 counties with the largest number of young people in their juvenile justice systems. It found that, in 2001, parents placed more than 12,700 children into the child welfare or juvenile justice systems so that these children could receive mental health services. This estimate is likely just the tip of the iceberg since 32 states – including the five states with the largest populations of children – did not provide the GAO with any data. In 1999, the National Alliance for the Mentally Ill released a survey that found that 23 percent of families caring for a child with a serious brain disorder had been told by public officials that they needed to relinquish custody of their children to get care. According to the survey, one in five of these families actually took that advice.

While some states have passed laws to limit or prohibit custody relinquishment, simply banning the practice is not a solution, since it can leave mentally ill children and their families without services and care. Custody relinquishment is a symptom of the much larger problem, which is the lack of available, affordable and appropriate mental health services and support systems for these children and their families.

In July, I chaired a series of hearings in the Senate Committee on Governmental Affairs to examine the extraordinary challenges faced by families of children with mental illnesses. We heard compelling testimony from families who recounted their personal struggles to get mental health services for their severely ill children. The mothers who testified told us they were advised that the only way to get the intensive care and services that their children needed was to relinquish custody and place them in the child welfare system. This is a wrenching decision that no family should be forced to make. No parent should have to give up custody of his or her child just to get the health care that the child needs.

That is why I recently introduced bipartisan legislation, the Keeping Families Together Act, that is aimed at combating the problems faced by many families with sons or daughters with serious mental illness. First of all, the legislation authorizes $55 million in matching grants to help states serve children suffering from mental illness more effectively and efficiently, while keeping them at home with their families.

In response to recommendations made by the GAO report, the Keeping Families Together Act also establishes a federal interagency task force to examine mental health issues in the child welfare and juvenile justice systems and the role of their agencies in promoting access by children and youth to mental health services. Finally, the legislation removes a current barrier that prevents more states from using the Medicaid home and community-based services waiver to serve children with serious mental health conditions. The Medicaid home and community-based services waiver is a promising way for states to reduce the practice of custody relinquishment and address the underlying lack of mental health services for children. Our legislation adds inpatient psychiatric hospitals and residential treatment facilities to the list of institutions for which alternative care through the Medicaid home-and community-based services waivers can be offered.

This legislation will help to reduce the barriers to care for children who suffer from mental illness and will assist states in eliminating the practice of parents relinquishing custody of their children to state agencies solely for the purpose of securing mental health services. It is my hope that, for the families across our country struggling with this most difficult of challenges, the Keeping Families Together Act will make it easier to provide their children with the family care they need.