Mental health care in the United States has been fragmented and disjointed for decades. The homeless problems in Albuquerque, New Mexico, the school shootings by distressed children across the nation, and increasing incidence of mental health related events throughout our nation point to a failed approach to dealing with mental health in our country.
On March 15, 2014, I began a 148 day journey of walking across the United States from San Diego CA to Ocean City, MD. The purpose of the walk was to raise awareness of the needs of children with emotional and behavioral problems and for those with developmental disabilities.
What triggered the walk, though, was the realization that government was not able to solve the growing problems associated with children in distress. Government, by its very nature, will prioritize effort based upon the political and funding needs in the short run versus the very real long run issues associated with mental health.
Government, in the past, has merely attempted to contain the "problem" rather than solving the problem. Containment allows states to develop short run "solutions" which serve to mask the problem versus finding long term solutions to cure the problem
In the case of childhood mental health, the nation has been provided with options over the past thirty years in which out-patient treatment has replaced residential care for children due predominately to the cost of treatment rather than the effectiveness of treatment.
In the same way those children qualifying only for outpatient treatment in the past are often now unable to avail themselves of any options for treatment unless the child’s problems escalate in such a manner as to put the child or society in danger or the family has the ability to pay for private mental health care.
In today’s government sponsored treatment systems, residential care for emotional and behavioral problems is either reserved for those able to pay privately or for those society deems are too dangerous for themselves or society to be in the open population.
In all of these efforts though, government seldom looks at either the causal factors influencing the surge of childhood behavioral and emotional problems, effective treatment protocols, or the long term costs to society, children and their families of ignoring the mental health crisis in the nation for children.
The mental health issues facing children will not go away by turning a blind eye to the problem.
During my walk across the country I met hundreds of homeless many of whom exhibited mental health issues needing treatment. Concurrently while going through Albuquerque, New Mexico, the Department of Justice issued their analysis of the problems with the relations between the police and the homeless in the city. The report focused on the way to "handle" or contain the problem rather than discuss the cause of the homeless and the lack of available and meaningful treatment options for the homeless and mentally distressed persons.
The solutions to the problems of child mental health issues requires a concerted, stable, well researched and, equally as important, compassionate approach to treatment.
During my walk, it became obvious through much prayer that the solutions to the problem require a faith based approach that is devoid of funding from federal, state or local government.
The effective treatment requires a nation to dedicate the talents of the entire mental health profession to do the following:
a. Research the causes of mental health issues in our society. A sound, logical, and well thought out study approach and methodology must be adopted which allows for evaluating causal factors devoid of political influences and preconceived analyses.
b. A faith based university must be encouraged to develop a school of psychology to train students in effective and compassionate treatments.
c. A continuum of care must be established to provide for early diagnosis, intervention and treatment in a step wise progression to allow for treatment to be provided in the most needed manner for the benefit of the child. Such continuum of care must include:
1 Community outpatient services
2 Home services to include family therapy
3 Parental guidance, assistance, training, and day care to allow the parents recuperative time so that they can patiently deal with the issues at hand.
4 In-patient services for intensive therapy
5 Residential services for long term intensive care
6 Step down services for those successfully exiting either in-patient or residential services to better provide for gradual and effective reintegration into society.
A faith based mission is to remember that every person and every life has value. Should a child be physically sick, we would all step in to help. In the case of mental illness, the current mental health system has failed.
It is critical to remember though that the issue of children is also about their lives, their families and their survival.
Col. Frank Ryan, CPA, USMCR (Ret) and served in Iraq and briefly in Afghanistan and specializes in corporate restructuring and lectures on ethics for the state CPA societies. He has served on numerous boards of publicly traded and non-profit organizations. He can be reached at [email protected] and twitter at @fryan1951.