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print email Source: Editorial: Taking taboo out of mental illness
Mental illness treatment gap
January 27, 2013 | 09:14 AM

I agree there is some taboo preventing self-reporting or reporting one's child. What might the repurcussions be, insurance wise, or opportunity wise? Of course there hesitation to take that risk. However, many mentally ill adults do not recognize they need help, and in any event do not function well enough to find care or pay for it, for instance, applying for help, showing up for appointments, carrying a job to pay for it that will allow this time off.
But care is simply not financially available for some children identified by parents and doctors to need expensive long-term treatment for mental illness. Here is a tragedy. Health insurance does not pay for about 4 days of residential treatment. It is private pay. The cost of residential care is $400-$2500 PER DAY. Most middle class families don't even gross that amount. If you are on Medicare, it is all good. But the same institutions are silent when you ask for help as private pay, they don't even offer it, and can't tell you anyone that does. BDDS (Medicaid waiver) rejects mentally ill kids from the medicaid waiver list in favor of physically and profound cognitive disabilities. Aspergers is simply not severe enough to be on the waiting list for help, applicants are routinely dismissed and allowed to appeal at their own expense. The schools acknowledge a problem but refuse to address it with their own budgets, they suspend the child. Ironically, schools chase down parents in title I schools to provide services that middle class moms beg for and don't receive. Schools are not accountable to actually spend the funds that children are entitled to on that child, many parents are unaware the school receives funding to help their child with Aspergers, for example.
The only way a middle class parent can get residential care for a child is to abuse or neglect the child and report it (put the child in the foster care system) and hope the state will recognize and address the mental illness before they time out of the system, OR divorce, quit working, and apply for Medicare for their child. Ironically, this results in fewer taxes paid into the system. These are not good choices for parents or children, so most don't do either, and their child goes without the care they need. I feel so badly for Adam Lanza's family, because the parents seemed to face these same obstacles, and did the best they could with the resources available, and it ended in tragedy that the parents probably could have forseen, but could do nothing to stop.
The new healthcare legislation does not address the above problem, either. In a catastrophic care situation requiring extended residential care for treatment of mental illness (to learn how to adapt to and function successfully in society), children who need help are entitled to care solely based upon their parents income (low being entitled). No surprise the kids shooting up schools typically come from the middle or upper middle class.

RF
Barbara Shaw
Schuler Bauer
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