GAO: Children not getting mental health help when they need it

A new report from the Government Accountability Office finds that many children who need mental health care are not getting it.

From The Huffington Post:

“Most children whose emotions or behavior, as reported by their parent or guardian, indicated a potential need for a mental health service did not receive any services within the same year,” the GAO wrote.

“The report comes after Sen. Tom Harkin (D-Iowa), Rep. Rosa DeLauro (Conn.), and Rep. Lucille Roybal-Allard (Calif.) requested that the GAO look into how psychotropic drugs affect the long-term development of kids who grow up in foster care. While the report is very specific in its scope, it’s sure to be a relevant piece of evidence as the Obama administration formulates policy to deal with the ramifications of the Newtown, Conn. elementary school shooting. The shooting has sparked a nationwide debate on gun control, but it has also directed America’s attention to the state of its mental health care system. “

“Here are some findings:

  • On average, 6.2 percent of noninstitutionalized children in Medicaid and 4.8 percent of privately insured kids received psychotropic medications.
  • 30 percent of foster children who might have required mental health care didn’t receive them over the last year.
  • Most kids outside the foster care system whose behavior displayed red flags didn’t receive mental care services.
  • Many kids who got psychotropic medication didn’t get counseling or therapy to complete the care.
  • While the National Institutes of Health spent1.2 billion on children’s mental health care research between 2008 and 2011, most of the funding focused on research studying therapy, rather than the effects of such medication. “

I think not getting mental health care is true for kids outside the foster care system as well and for many reasons

I think in many cases parents aren’t open to the idea of getting psychological help for their kids. They don’t believe in therapists or think it’s embarrassing.

I think a lot of mental health professionals don’t take insurance so the cost is prohibitive. I think a lot of the public facilities that offer care inside insurance programs or for free are overwhelmed by children who need help.

I think many school systems would rather punish kids and force them out of the school than help provide the mental health supports they need.

Sen. Harkin said the study was alarming and I agree there is much work to be done for mental health care for children (and adults).

Does it surprise you that parents wouldn’t get psychological help for their kids when it was indicated that it was needed? Have you encountered mental health professionals that won’t accept your mental health insurance benefits? Do you think it’s hard to find mental health professionals that you feel good about for your kids? What do you think of this study?

23 comments Add your comment

catlady

January 11th, 2013
6:41 am

My observations: If there is a check involved, parents will admit their child needs help. No check? Much less so.

If medication is recommended, half the parents will say no, there is nothing wrong with him. He is just “being a boy.” For the other half, a third to half of them will either take the medicine themselves, or sell it for the money. A few will give it to the kids regularly; the others will give it “if they happen to remember to.”

As far as “just” counseling, if it gets the meds/check, it will happen. If parents are supposed to be counseled as well…not so much.

Just my observations from my little part of the world.

catlady

January 11th, 2013
6:47 am

One other observation: A child will tell you, “You can’t expect me to follow the rules. I have___(fill in ADHD, “anger management issues,” etc).”

catlady

January 11th, 2013
6:51 am

Oops! I left out OD(Oppositional-defiant) disorder. That means that what you ask the kid to do, she does not comply.

Jeff

January 11th, 2013
7:31 am

Thanks cat, my thoughts exactly, but you said them much more clearly and concisely.

Basically, we have a generation of dysfunctional parent(s) and broken system that has failed to live up to the promises and money taken to fulfill those promises.

When I was a kid, these behaviors would have resulted in a parent (usually the dad) yanking a knot in the child and making life so uncomfortable that eventually, the child got back into line. Now that dads arent allowed to be dads anymore, and discipline is no longer allowed, well, you see the results.

Voice of Reason

January 11th, 2013
7:43 am

The first thing I did when my boy started showing signs of ADHD was talk to his pediatrician. Having spent my whole life dealing with it myself, only without the Hyperactivity part, I knew EXACTLY what to look for. He couldn’t sit still, even for a few minutes, and he would climb on furniture and chairs and try to make things do other than what they were intended to do. He wouldn’t listen to reason either, he’s 5, why would he? But when I saw the boys that I coach T-ball for were younger than my son and not behaving the way my son did (not staying focused and running around the outfield like a madman, even though we would ask him every game if he wanted to be there and he would say yes) was the red flag for me. He couldn’t cope with the tedious parts, even if they were part of something he loved doing. He would flail his hand around and run 90-to nothing knocking down other children too. Not because he meant to, but because he just could not sit still. I knew I had to do something before he inadvertently hurt himself or others because he of his impulsiveness, he doesn’t think before he acts. And no amount of trying to explain it to him would help.

He’s on medication (Ritalin) now and doing extremely well in school and his behavior has improved dramatically. It’s like night vs day. He listens, he doesn’t immediately melt down when he doesn’t get his way like he would without meds, he can be reasoned with, and he thinks before he acts. Being on the medication has allowed my wife and I to let my boy see what good behavior is. The doctor even commended us for taking action sooner, rather than later. Most kids have to find out the hard way that they need medication.

And in before the anti-medication Nazis. I’ve seen first hand how medication helps. Medication given for the right reasons is a benefit. I don’t care what you say about it.

Jeff

January 11th, 2013
8:03 am

I have a question for anyone who may know. My GF has a daughter that is a brittle juvenile diabetic. She has serious issue when it comes to remmebering to do even the most basic routine tasks that she’s done a million times. I’m convinced she has ADHD, but the doctors won’t even talk about it until her sugar gets under control and she finishes pre-puberty.

Has anyone ever seen or been through anything like this child before? I believe she also needs some basic rules, routinely enforced so she starts to learn boundaries. But the bigger problem is she will be in middle school next year, without a nurse to tell her to check her sugar, and she is completely incapable of remembering to do it herself.

Any tips?

catlady

January 11th, 2013
8:12 am

I think you are right to note and push with the doctor her ADHD or OD (oppositional defiant) as her sugar will NEVER be stable without those under control! JMHO

Voice of Reason

January 11th, 2013
8:17 am

@Jeff

Doesn’t sound like ADHD to me. I mean, we forget stuff sure, but basic routine tasks like brushing teeth or combing hair are usually not a problem. If she weren’t so young I would say she had early onset of Alzheimer’s.

Performing longer tasks, that we start many of, but then never finish. That is ADHD. Because at some point things get tedious and we lose interest and move on to something else, or we start something, then get a great idea for something else, and rather than risk forgetting the new great idea we start that instead, thus neglecting the task we started in the first place.

mystery poster

January 11th, 2013
8:26 am

@catlady
I’ve always loved that, ODD. Can you imagine this scenario:

Interviewee: I have ODD, that means when you tell me to do something, I won’t be able to do it. It also means that I may tell a customer to F off when they make me angry.

Interviewer: When can you start!

motherjanegoose

January 11th, 2013
8:38 am

@catlday…I am with you. I taught children who needed speech therapy and the parents were in denial. When the Kinder teacher recommended it for my son, we valued her opinion and he went. We worked with him, several times a week, on exercises. It is so important to start early.

[...] not getting mental health help when they need it – Atlanta Journal Constitution (blog) GAO: Children not getting mental health help when they need itAtlanta Journal Constitution (blog)“Most children whose emotions or behavior, as reported by their [...]

Jeff

January 11th, 2013
10:06 am

Voice, thanks. She struggles with anything that requires her to pay attention and make an effort to complete. Be it longer tasks like homework or a project, or cleaning up her room.

I know with the sugar swings that it’s difficult to slow her mind down when her sugar is above a certain level. So it’s difficult to tell when she just flat out WON’T do something versus when she is mentall unable to actually hear you finish a sentence. I’ll give you a basic exmaple: She’s required to check her sugar each time before she eats. She’s been doing it every meal for 6 years. If someone doesn’t remind her, she doesn’t do it. The blame everyone else part is just an 11 year old being an 11 year old.

The difficult part for me is, as an adult, you treat someone differently if the are mentally not capable of something versus how you treat them if they are unwilling but capable. Sadly, it’s going to be a lifelong battle for her on so many levels just to be able to manage her own life.

Voice of Reason

January 11th, 2013
10:28 am

@Jeff

It sounds to me like she just doesn’t want to do it. You would have to make sure her bodies ability to process sugar properly has been addressed before you could ascertain whether her brain lacks the ability to produce enough Dopamine, which is basically the chemical imbalance associated with ADHD, and why stimulant medications like Ritalin are often prescribed to compensate.

You could always talk to a doctor and see about putting her on a VERY low dose of ADHD meds to see if they improve her memory function at all. Basically, if you don’t need ADHD pills, it’s like taking Speed, it will have the reverse effect you are looking for. Instead of calming her down, she’ll be climbing the walls, or so I understand from what I have read and heard anyway.

Tired

January 11th, 2013
10:42 am

In all fairness to parents, some don’t want their child to carry a lifelong diagnosis/label that can affect their future job prospects, insurability, etc. I’m certainly not defending anyone who chooses not to get help for their child, but please know that sometimes it’s a difficult choice and not a denial issue.

[...] health help when they need it – Atlanta Journal Constitution (blog) The Libertyweb GLOBALGAO: Children not getting mental health help when they need itAtlanta Journal Constitution (blog)“Most children whose emotions or behavior, as reported by their [...]

Voice of Reason

January 11th, 2013
10:52 am

@Tired

My kid, right before he had his medicine approved and right after the Connecticut school shooting had a VERY bad meltdown in a store. Every adult in that store stopped and stared at my kid wiggling on the ground throwing a tantrum like he was the next Adam Lanza. I wouldn’t wish that experience on ANY parent.

I think if parents actually give a crap about their kids they would do WHATEVER was necessary to prevent their kid from becoming that and not hiding behind some stupid excuses for not addressing their child’s problems BEFORE they escalated into something dangerous.

mystery poster

January 11th, 2013
11:03 am

@Jeff
Dads are still allowed to be dads.

Theresa Walsh Giarrusso

January 11th, 2013
11:18 am

Voice of Reason — I absolutely agree that some kids do need the medicine. It helps them feel better about themselves and do what they are capable of doing. It’s frustrating to them when they can’t do what they know they can and should be able to do.

Jeff — I would pursue a second opinion. I don’t know how blood sugar would affect other issues but I agree with you that the she’s not going to be on top of the blood sugar issue if she has other things going on — I think it may need to be dealt with concurrently instead of waiting for one to settle out.

3schoolkids

January 11th, 2013
12:39 pm

Part of the problem is continuity and coordination of care between providers, it is difficult for privately insured kids and would be especially difficult for kids in the foster care system. Caring for anyone with a chronic health problem is difficult on it’s own and the greater number of providers involved the harder it gets. This is also complicated by the difficulty in finding the right mental health care professional for your child.

@Jeff, blood sugar impacts the brain in significant ways. Imagine a battery with no life left in it, the brain is dependent upon glucose for energy. The brain controls all body systems so if it is lacking energy, all of the systems are too. Is she seeing a psychologist to help determine if her behavior is medical or a result of her inability to cope with handling her disease? My son gladly takes all of his medicines for his condition but will lie about pain or symptoms to avoid having to go to the doctor or have bloodwork done. A good psychologist can really help with that.

[...] health help when they need it – Atlanta Journal Constitution (blog) The Libertyweb GLOBALGAO: Children not getting mental health help when they need itAtlanta Journal Constitution (blog)“Most children whose emotions or behavior, as reported by their [...]

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catlady

January 12th, 2013
10:33 am

VOR: some folks think too many kids are medicated. I think around here it is too few. However, I agree with you: medicine, once adjusted, can mean academic life or death for kids who need it. I am sure there are kids somewhere who get the medicine who actually need better parenting, but for those I see it is a lifesaver! Unfortunately by the time some get it, they are already 3-5 years behind academically, and have adopted behaviors that are hard to break.

I get very angry about our kids that have a prescription whose parents find other uses for the drugs. I also feel angry about parents who refuse to try it for their kids. Would they deny their child heart medicine if they needed it?

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