I had a conversation last week with a consultant who worked in Los Angeles Department of Mental Health for 36 years overseeing children’s mental health services. He’s seen many changes. The most profound, perhaps, is the amount of money available now vs. then in the 80s when it wasn’t believed children could have mental health issues.
People often ask me whether they think too many kids are being diagnosed with this and that, or if we are just learning more about the brain and are not sticking our heads in the sand as was our legacy from the 50s. My experience has been that families struggle to get a diagnosis, and that it can take years to get a correct one. In my 20 years of interfacing with stories involving the mental health system I’ve never heard a parent/grandparent/caretaker say, “Wow they rushed in on that diagnosis.”
But outside that controversy, we can probably all agree on one thing: as a community, we are ill-prepared to deal with the amount of children and teens (counting transitional youth, or TAY as they’re known in agency circles) that are suicidal, depressed, or spinning out in some way that is destructive to them, their families, and their communities. This is true across the country, world, and in both urban and rural areas. However, rural areas have their own set of challenges, and I have seen those in Shasta County.
First, there are agencies like Department of Mental Health. I’ve never interfaced with this department personally, but I’ve heard stories. My sense is–and I have no first hand knowledge–that the agency works for those patients who qualify at a certain economic level. In classes I’ve taught, I’ve heard foster parents talk about wrap-around services for the foster kids. I’ve heard people who qualify for Medi-cal talk about services for their kids. But I don’t hear or see too many solutions for the kids on the edge who are still living with their original families, and whose families make too much money to qualify for services, but not enough to fund all the help they need.
For these children, not only are they prevented from services to help their families and themselves on the agency side, but they also struggle to find help in the private sector. Even if they have insurance and can pay the high fees/co-pays for psychology professionals, finding them is a near impossibility in rural areas. Mental illness is not a poor people disease. It is an equal opportunity disabler.
This has been a frustration of mine over the past few years. I hear the parents of children/teens/TAY talk about how they’d like to help their kids (and they know something is wrong), but had no idea where to turn and find their loved ones in prison/dead/run away. Tragic endings where there didn’t need to be.
But this week I saw a rainbow in this cloudy conundrum. Following my conversation with this previous employee of DMHLA, I felt inspired and hopeful. He has been a consultant on a program that USC has been piloting using the Telemed idea of Skyping with patients. They have joined forces with LA County and are on the final stages of joining with United Advocates for Children and Families to set up shop in Monterey County. The families have access to care several times a week via computer and high speed internet. If that is not a resource they have at home, a “suite” is set up near the home that they can use. It is my dream that all levels of income can activate this system at some point.
Why? Because the results have been outstanding. In fact, 75% of families say this has worked as well or better than in person meetings. Some reasons are they don’t have to take their mentally ill child (who have been known to try and jump out of moving cars in an episode) to an appointment. The child’s more apt to show their true colors in their own atmosphere. Additionally, more people can be seen by multiple therapists through this system instead of just having one per county with a list so long there is no possible way kids can be seen.
Early intervention with children is key. Procrastination (either by family or professional services) can cause irrevocable brain damage and emotional trauma. This Telemed system just might be one answer to how we avoid losing kids while we fix our broken mental health system.