On Saturday morning I attended a meeting about mental health issues in very young children, 0-3 years old. We often don't think about mental health problems in kids that young, and I have to admit I learned alot about a subject that I wasn't at all familiar with.
There are very few programs set up to intervene and help in situations in which mental health issues can be identified at that age. But think about...if a child is being raised in an abusive, violent setting, then the effects are going to begin showing up at an early age. Proper early intervention and treatment could dramatically improve that child's future.
Later Saturday, I met with a group of mental health provider and advocates to talk about the effects of the mental health reform on service in Orange County. It was an excellent meeting, and--oh boy--did I get an ear full. We talked for over an hour and probably could have continued for another 3 or 4. Concerned about the mental health service cuts, they listed obstacle after obstacle: from cuts in reimbursement rates, to problems with medicaid, to lay-offs from private firms that now have contracts to provide service, to excessive and confusing paperwork. For example, one provider had to submit 5,000 pages of documents last week because of a random audit. It took 3 staff people 2-3 days to pull all the documentation together. That's time away from serving clients and away from providing much needed care.
We also talked about problems such as the situation with Caring Family Network which I posted on yesterday. These private for-profit entities, which are now responsible for providing care in most of our counties, are responsible to shareholders NOT patients. They're businesses, pure and simple. When these companies find they can't make money providing mental health care at the current levels, they have a fidicuary responsiblity to cut costs somehow. Those cuts come in the form of reduced staff and reduced hours. As I said yesterday, some services just shouldn't be privatized.
Another problem that came was the cuts in reimbursement rates for certain services. This has led to a number of problems, including a reduction in the quality of care. For example, some providers can only afford to pay highschool graduates to perform certain tasks. So, services that were once provided by master's level staff are now provided by folks with far less education. Don't get me wrong, there's nothing wrong with having a high school education. But some forms of care are best performed by trained staff with the education to back it up.