A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

“Why on God’s green earth does it take all that to get help?”

“Why on God’s green earth does it take all that to get help?”

February 20, 2009

Judith Warner’s piece in the New York Times has lit up the email lists of children’s health advocates. In the span of less than an hour this morning, several colleagues sent me the article independent of each other.

Insight into systemic problems often come from the most unlikely places: very few could have ever predicted that a Nebraska law intended to prevent new mothers from abandoning newborn infants would expose troubling shortcomings in the ability of the health care system to address mental illness.

Because the Nebraska law failed to include an age limit on the children it was intended to target, dozens of young people, many teenagers and many from outside the state, were left with local authorities by parents or guardians. As Ms. Warner writes, these parents abandoned their children often out of desperation – a desperation borne, in many cases, from an inability to access care and services for their children’s mental health needs.

Nebraska’s story is not one of poorly written legislation or one of bad parents. Instead, it is a cautionary tale about a long-standing and ever-growing crisis within the mental health system.

The safe haven law merely revealed the tip of the iceberg.

The provincial nature of Massachusetts being what it is, perhaps we would like to minimize the significance of what happened half a continent away. After all, isn’t our state the national leader in health care? Don’t we have the best hospitals in the world? Isn’t our uninsurance rate the lowest in the country? Aren’t we the exception?

Sadly, in many ways, the Bay State is not much better off than Nebraska when it comes to treating mental illness in children:

  • In Massachusetts, of the 140,000 young people with in need of mental health treatment each year, 100,000 do not get the necessary care;
  • 50% of teenagers with mental health needs drop out of school – the highest percentage of any disability group;
  • Suicide is the third leading cause of death for young people between the ages of 10-24. Of those who commit suicide, 90% have a diagnosable and treatable mental illness at the time of their death.
  • Thousands upon thousands of families right here in Massachusetts are living lives of desperation for lack of access to mental health treatment. We have significant shortages of children’s mental health clinicians all across the state. The stigma of mental illness is such that many requiring services are afraid to admit they need help. Care coordination remains a significant issue, exasperated by recent reductions in mental health case managers necessitated by budget cuts.

    Families need help, but our system is failing them.

    We are not nearly as far from being in the same situation as Nebraska as we might like to think.

    Health Care For All is part of an ever-growing coalition of advocates, families, and policy makers determined to make changes in the children’s mental health system. The Children’s Mental Health Campaign successfully advocated for the passage and enactment of An Act Relative To Children’s Mental Health (Chapter 321 of the Acts of 2008) which attempts to coordinate care, encourage early identification, and provide new tools to families and schools that will help young people with mental health needs.

    The passage of the law alone is not enough to fix all the problems. It will take hard work to destigmatize mental health needs, bring it out of the shadows, and fully address the medical crisis associated with untreated mental illness.

    The time is NOW to make this happen.

    Matt Noyes
    Children's Health Coordinator