Volume 16, No. 2, Spring 2008
By Larry Fox
Landmark programs that would provide state support for home-based treatment of mentally ill children throughout the Commonwealth with the goal of avoiding institutionalization whenever possible are in the works. Cape Cod and the Islands are expected to play a key role in implementing some of these initiatives.
Here is the background.
In January of 2006, a District Court judge sitting in Springfield ruled that the Commonwealth of Massachusetts had violated federal law by failing to provide satisfactory behavioral health services to children with serious mental health issues.
He described the estimated 15,000 children as “the most fragile members of our society” and noted in his 98-page decision that many were “forced to endure unnecessary confinement in residential facilities or to remain in costly institutions far longer than their medical conditions require.”
This ruling was made in the class action Rosie D. v. Romney lawsuit on behalf of nine young plaintiffs hospitalized or facing the risk of hospitalization due to the state’s failure to provide these home-based services.
This Rosie D. decision has led to a legislative proposal co-sponsored by two Democrats, Representative Ruth B. Balser of Middlesex and Senator Steven A. Tolman of Greater Boston, SB 2518: An Act Relative to Children’s Mental Health.
The basic goals of the bill are threefold:
As the bill wends its way through the legislative process, other initiatives are reported to be under consideration as well. And these may introduced in local regions such as the Cape.
The goal of these, as with the Rosie D. legislation, would be to provide a continuum of care for youth at risk of out-of-home placement and to allow them to continue living and learning in their home communities. Coverage in some programs would not necessarily be tied to insurance.
The National Alliance on Mental Illness (NAMI) of Massachusetts is strongly supportive of the Balser-Tolman bill. A keynote of their annual State House Lobby Day called for “family-centered Children’s Mental Health services” through establishment of a “comprehensive” statewide system.
Their position paper declared that “the failings of the current system have led to a crisis for children and adolescents with mental illness and their families.”
They stated that “treatment must be family-centered in order to be successful and sustainable.” They added that early screening and diagnosis, in-school support and transitional assistance were essential.
In a poignant paragraph in their position statement, the NAMI advocates wrote in describing the situation of what some call “warehousing” when Rosie D. v. Romney was filed:
“Many children in crisis were not able to access the services that they needed. Those who were able to receive acute care in hospitals (but) now were ready for a less restrictive, but still supportive environment had no place to go. They remained in the hospital and thus were dubbed ‘stuck kids.’”
This and other programs are designed to help eliminate what NAMI called the “unacceptable growing issue of stuck kids in Massachusetts.”