States Failing to Meet Children’s Mental Health
Needs
New Report Details Policy Options for Increasing Access
to Mental Health Services
Washington, DC – Despite a deepening crisis in the public mental
health system for children, states are underutilizing policy options that
would increase access to mental health services, according to a new report
by the Bazelon Center for Mental Health Law, the nation’s leading
legal advocate for the rights of people with mental disabilities.
The report, Avoiding
Cruel Choices: A guide for policymakers and family organizations on Medicaid’s
role in preventing custody relinquishment, was released today at the
national meeting of the Federation of Families for Children’s Mental
Health in Washington, DC. The publication spells out how Medicaid covers
mental health services and describes state policy options for increasing
families’ access to services.
“States are failing children with mental health care needs in many
parts of the country,” said Chris Koyanagi, policy director at the
Bazelon Center and author of the report. “Laws already on the books
could provide immediate relief for these families, yet few states are
really using them.”
More than 15 percent of the nation’s children are uninsured, according
to a 1998 study by the Kaiser Foundation, and many of them lack access
to mental health services. Because many of the uninsured have at least
one working parent, they are often ineligible to receive such services
through Medicaid.
Even children who are covered by private insurance routinely experience
difficulties in obtaining mental health services. Almost all private health
insurance plans impose limits on both inpatient and outpatient care. Ninety-four
percent of health maintenance plans and 96 percent of other plans have
restricted mental health benefits, according to the report.
The lack of access to mental health services has tragic consequences.
Many families who cannot get mental health services for their child give
up custody of their child to the state to secure services – a practice
documented in more than half the states.
“Custody relinquishment is absolutely devastating to the parent-child
bond,” continued Koyanagi. “It shouldn’t have to be this
difficult for families to get services, and it wouldn’t be if states
were making better use of Medicaid policy options for covering these children.”
Avoiding Cruel Choices discusses two such options in detail: the TEFRA
option (named after the Tax Equity and Fiscal Responsibility Act of 1982
that created it) and the Medicaid waiver that allows states to fund home-and
community-based services.
These options allow states to cover children with significant mental
disorders and dramatically reduce pressure on families to give up custody
of their child, according to Koyanagi.
“It is a shame that so many families are suffering needlessly when
we could so easily reduce the need to choose between a child’s mental
health and preservation of the family,” concluded Koyanagi. “We
hope this report will encourage policymakers and families to make better
use of these options.”
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For three decades, the Bazelon Center for Mental Health Law has been
the nation’s leading legal advocate for the civil rights and human
dignity of people with mental disabilities. For more information, please
visit www.bazelon.org.
Chris Koyanagi is policy director at the Bazelon Center for Mental
Health Law. With more than twenty-five years of experience as a government
affairs specialist in the mental health and disabilities fields, Koyanagi
is one of the nation’s leading experts on mental health policy.
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