Kansas Health Institute | Information For Policy Makers. Health for Kansans.

BASEHOR — Tracy Rhodes says the recent change in state policy intended to discourage use of psychiatric facilities for children has added stress to her already stress-filled life.

“I don’t think it’s right that, because there’s a problem with the budget, that it’s OK to hurt families and damage kids,” she said.

Rhodes’ 16-year-old daughter, Carley, has tuberous sclerosis, a genetic condition that causes aberrant behaviors. She’s also developmentally disabled.

Last month, Rhodes, who lives in the small town of Basehor in Leavenworth County, asked that Carley be admitted to Lakemary Center, where she'd been for five months in 2010. Lakemary is a residential treatment center in Paola, which is in Miami County.

The mental health center in Leavenworth denied Rhodes' request, saying the services needed by her daughter could be provided locally.

Safety concerns

Rhodes asked that certain details about her daughter's behavior not be made public, but her activities last week were such there was reason to fear for the girl's safety or that of others.

“What had happened was Carley’s behaviors kept escalating to a point where it became unsafe,” the mother said. “We’d been through a lot of defiant-behavior kinds of things like hitting, kicking and spitting, but this sort of took things to a new level.”

Rhodes said the mental health center said it would arrange to have attendant-care workers help with Carley’s care and would provide individual psycho-social therapy for an hour a day, four days a week.

“I cried all the way through the meeting,” she said, noting she was told to call police if she couldn’t handle Carley’s behaviors.

“They also said she could go to an acute-care psych unit for three or four days, but we’ve done that four or five times already,” she said. “What I couldn’t get anybody to understand was that these were all short-term solutions. I wanted us to talk about a longer-term solution to break the cycle of behaviors and to stabilize her.”

Rhodes appealed the mental health center’s decision, which, last week, was reversed.

Carley today was admitted to Lakemary Center.

“It was nerve wracking. I had to paint the worst possible picture of my daughter,” Rhodes said. “I got her approved, but it was a very stressful process, something a parent should not have to go through.”

One in five

According to University of Kansas researchers, one in five children has a diagnosable mental illness. One in 10 has a problem severe enough to disrupt daily functioning. Children in low-income homes are considered more at risk of mental illness.

According to a report prepared by the researchers (PDF) under contract to the Kansas Department of Social and Rehabilitation Services, although more than 3 million children a year nationally receive mental health treatment, an estimated 50 percent to 80 percent of those who need services don’t get them.

The researchers reported:

“Despite national recognition of the scope and significance of children’s mental health needs...children and families face several persistent barriers (to care). Communities and state governments have a long history of discussing reforms of children’s mental health care. Currently these deliberations occur in an environment of rising health care costs and government budget shortfalls. The paramount challenge is finding an appropriate balance between institutional and community-based services so that children’s needs can be met and limited government resources used efficiently. Compounding these enduring and complex questions is a lack of uniform, comprehensive data on which administrators and policymakers can rely to make effective policy decisions.”

Few child psychiatrists

The researchers said that only 11 of 105 Kansas counties had a licensed child psychiatrist. Fifteen of the state’s 28 community mental health centers did not have a child psychiatrist within their catchment areas. However, they found no link between admission rates to treatment facilities and the availability of psychiatrists.

During fiscal 2009, the researchers found that 1,912 of the 178,558 Medicaid-eligible children in Kansas between ages 3 and 17, were admitted once or more for inpatient psychiatric care. They reported 2,919 admissions in 2009, up nearly 8 percent from the 2,711 admitted in 2008. Many children, about 43 percent, were admitted more than once during the year.

The increase in admissions coincided with an 8.7 percent increase in the number of Medicaid-eligible children with serious emotional disturbances served by community mental health centers during the same period.

The researchers identified two significant problems with the state’s current system for dealing with mentally ill children.

One was “potential underservice to children when inpatient service is too short to accomplish meaningful change.”

The second was repeated hospitalizations as a consequence of the first problem.

Researchers suggested the system could be improved by facilitating coordination of treatment and by strengthening the ability of community mental health centers to work with parents so they would be better prepared to deal with their children once they were released from residential treatment facilities.

Related stories

→ Changes underway at SRS

→ Budget cuts lead to fewer children admitted for psychiatric treatment