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Cutbacks in Youth Mental Health Care

June 18, 2002

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CHICAGO (AP) _ Demand for mental health treatment for young people has reached unprecedented levels, yet cutbacks in several states are making it more difficult than ever to get care, experts say.

Across the country, young patients in crisis are having to wait two months or more to get an appointment with a psychiatrist or social worker. And services for those needing long-term psychiatric care are even more scarce.

``It’s a crisis. It’s reached epidemic proportions,″ said Dr. Rob Garofalo, an adolescent health specialist at a clinic for teenagers and young adults that Chicago’s Children’s Memorial Hospital recently opened on the city’s North Side.

A first-ever mental health report issued by the U.S. Surgeon General’s office in 2000 found that about 11 percent of youths ages 9 to 17 _ about 4 million people _ have ``a major mental illness that results in significant impairments at home, at school and with peers.″ About as many more have less serious mental health problems of one sort or another.

Despite the demand, already scarce services are dwindling.

There is a nationwide shortage of psychiatrists and mental health workers who specialize in youth.

In Chicago, Minneapolis and other cities, cash-strapped hospitals have been closing psychiatric wards for young people, who are expensive to treat because so many have no medical coverage.

Several states, including South Carolina, Missouri and Nevada, have cut their mental health budgets. And states such Illinois and California, where $96 million in mental health funding is on the chopping block, may do the same. Congress is considering cuts of its own.

The shortage of services nationwide is so glaring that some health-care providers have a term for mentally ill youth who come to hospitals and end up in general care wards because there is nowhere else to put them: ``boarders.″ Others are being housed in psychiatric hospitals and even nursing homes with adults much older than them.

``I was always put on the back burner because I was the youngest,″ said Michael Gill, a 22-year-old San Franciscan who was placed in a psychiatric hospital with older patients at 18 and started living on his own a year ago.

Michael Lasco, a 25-year-old Evanston, Ill., resident who suffers from severe depression, was in much the same situation until last year.

Now the nonprofit agencies that helped both men find independent housing, jobs and start studying to get their high school equivalency diplomas stand to lose funding and staff.

For Gill, that agency was CVE, a San Francisco-based vocational organization that helped him become a nurse’s aide. If the California budget is approved, agency chief executive Michele Tatos anticipates cutting a staff position, even though the number of mentally ill youth her agency serves has increased 127 percent in the past three years.

Last year, Lasco came to Trilogy Inc., a Chicago-based organization that helps the mentally ill live independently. Now proposed budget cuts in Illinois and money-saving measures will probably force him to another agency, where he will start over with a new caseworker.

Some states, such as New York, are not cutting their mental health spending on youngsters but have refused to boost funding, said Dr. Raul Silva, a child and adolescent psychiatrist at the NYU Child Study Center.

``You just don’t have the person-power because you’re using the same dollars and cents that you used five and 10 years ago,″ he said.

The rising demand for services is attributed both to an increased awareness of mental illness and to what many perceive as a more stressful world for today’s young people.

Silva, the NYU psychiatrist, said he and his colleagues are seeing more than twice the number of children in outpatient clinics compared with two years ago.

In Boston, Carol Glod, a pediatric nurse and professor at Northeastern University, said she regularly gets calls from parents desperate to find help for their children.

``Your child is depressed or suicidal,″ Glod said. ``And they’re hearing, `We can schedule something for September.‴


On the Net:

Surgeon General’s mental health report: http://www.surgeongeneral.gov/library/mentalhealth/

Families for Depression Awareness: http://www.familyaware.org


Martha Irvine can be reached at mirvine(at)ap.org

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