Every young person is fully prepared for adulthood, with a supportive family and community, an effective school environment as well as high quality healthcare. According to the New York State Office of Mental Health 2008 Children’s Mental Health Plan is introduced with the above strategy supporting the American dream.
However, as we know for the American reality: 1) Studies indicate that at least 1 in 5 children and adolescents have a mental health disorder; 2) At least 1 in 10 has a serious emotional problem; 3) When untreated mental health disorders lead to school failure, family conflicts, substance abuse, violence and even suicide; 4) Suicide is the third leading cause of death for 15-24 year olds in our society.
As we also know, mental health disorders in children and adolescents results mostly from biological and environmental causes. Biological causes include genetics, chemical imbalances in the body, damage to the central nervous system such as a head injury, etc. Environmental factors also put children at risk for mental health disorders: – exposure to violence, i.e., being a witness or victim of physical or sex abuse; stress related to long term poverty; loss of significant people due to death, divorce, and broken relationships.
Some of the major themes and recommendations that are offered in the Office of Mental Health’s Children’s Mental Health Plan which has emerged are that: 1) Each action should strengthen our capacity to engage and support families in raising children with emotional health as well as resilience; 2) Social and emotional development and learning form a foundation for success in school and in life; 3) Major emphasis is needed in identifying children and families needing supports and services, early and in natural settings; 4) State agencies and service providers must be accountable to individual families for more integrated and effective care; and 5) An adequate workforce that is culturally competent and steeped in a new paradigm of integrated and family driven care should be developed and sustained.
Stigma continues to be a problem even though many educational campaigns have been offered throughout the state including Nassau and Suffolk counties. In 2007-08 the Mental Health Association together with Nassau County Department of Mental Health, Chemical Dependency & Developmental Disabilities undertook a comprehensive anti-stigma campaign, i.e., radio spots, media ads, as well as hundreds of picture posters of real life people with mental health issues being distributed throughout the county; in addition, the following year, Nassau and Suffolk counties also promoted (NAFAS) a far reaching anti-stigma campaign on Substance Abuse Disorders. However, there still continues to be profound societal misconceptions about the terms of disorders, and mental illness and mental health which tend to limit our ability to break down such barriers (NYS Office of Mental Health’s Engaging in the next step 2008).
In New York state a unified commitment was made in 2006 (The Achieving the Promise Initiative) which represented the largest investment in child mental health in the state’s history. Action occurred thru these initiatives introduced by a public health approach to early identification and intervention, widespread access to treatment, etc.
Also in 2006, the Children’s Mental Health Act was passed which was a call to action to families, providers, advocates, communities and policy leaders that social emotional development for children is a priority! Legislation then provided collaboration between the Office of Mental Health and the State Education Department to foster social and emotional development and learning to improve the emotional well-being of New York’s children. Thus, the plan was centered on enhancing social emotional development and on mental health, NOT mental illness.
Major medical, psychological or sociological theory recognizes that we develop emotionally – as well as physically, yet historically we have not integrated mental and physical health in our communities and in our public policy.
Sadly, in spite of great efforts, our specialized child serving systems are fragmented and difficult to navigate for families with multiple needs. It remains quite difficult for these systems to achieve the simple goal of effectively dealing with the most complex needs of the children they are designed to serve (New York State Children’s Plan). However, even with resources children suffer because of our collective inability to really integrate our services. State agencies need to work towards integrating services and improving outcomes for children and families. The Council of Children and Families in New York State is committed to an aggressive effort to improve access to appropriate care those who require services from multiple agencies. They will develop and oversee a Children’s Action Network (CAN) within
each county to coordinate local child service systems.
There still is hope. Quite significantly, the OMH, OMR&DD, Office of Children and Family Services, and the Office of Alcoholism and Substance Abuse Services continue the Building Bridges Initiative to develop multiple use, joint licensure and flexible funding across agencies to better support integration of services to benefit all children requiring help. NYS OMRDD in conjunction with OMH have made beginning strides to bridge the gap with addressing the needs of the developmentally disabled child who also has mental health needs. In addition, OASAS and OMH have made greater strides in working with substance abuse and co-occurring disorders to combine a truly integrated treatment model. As a matter of fact our agency, South Shore Child Guidance Center has further incorporated additional psychiatric hours to accommodate our substance abusing adult population. Since we instituted mental health screening in this population there has been a 27% increase in psychiatric evaluations as well as prescribing appropriate medication for those clients who require it.
Strategic planning by OMH utilizes a basic design of the “Balanced Scorecard Approach” for the Public Health System (2006-2010 Five Year Comprehensive Plan for Mental Health Services). In addition to their mission, their Strategy and Vision is an exceptional one: … a future when everyone with a mental illness will recover, when all mental illnesses can be prevented or cured, when everyone with a mental illness at any stage of life has access to effective treatment and supports – essential for living, working, learning, and participating fully in the community.
The need for services has never been greater! The Children’s Plan as well as The Achieving the Promise Initiative are transformational for services but can they become a reality in light of the impending NYSOMH Clinic Restructuring Program which may devastate the availability of services which are paramount to achieving this vision? We hope that the many children we treat, who are most often in significant distress will be able to benefit from all of these values which we embrace, and services which we consider to be of such high value. All our children should be given the opportunity to achieve their potential and live productively in their community. We hope this can be realized for their future.