This article originally appeared in the July-August 2002 issue of the Children's Advocate, published by Action Alliance for Children.

Spotlight on children's mental health

By Meeta Malhi

To balance California's 2002-2003 budget, Governor Gray Davis proposed eliminating all $35 million in the state mental health budget for "children's systems of care" programs, which pull together comprehensive services for children with mental health problems and their families.

The proposed cut would come at a time when recent state and federal reports on children's mental health have emphasized the need for a major new commitment of resources to the kind of integration being developed by "children's system of care" programs.

"Growing numbers of children are suffering needlessly because their emotional, behavioral, and developmental needs are not being met by the very institutions and systems that were created to take care of them," wrote Surgeon General David Satcher, author of one of the reports.

Cries for attention

Last year both Satcher and California's Little Hoover Commission published reports calling for significant improvements in the quality and delivery of mental health services for children, including:

• Universal mental health coverage, through a combination of public subsidy programs and better private insurance
  
  
• More resources for prevention and early intervention, rather than waiting until the problems are severe
  
  
• Integration of mental health services to both unify the fragmented mental health system and connect it with others, such as health care, schools, child care, and foster care.

Attitude problems

But "mental health services will continue to face budget cuts and other limitations," says Toby Ewing, author of the Little Hoover Commission report, "until the general public, employers, and others recognize quality mental health care as a community priority."

Satcher specifically pointed to the "stigma associated with mental illness" as a major barrier to helping children. With his National Action Agenda for Children's Mental Health he aims to "promote public awareness of children's mental health issues."

Legislative proposals

Several bills now in the California legislature would implement some of the Little Hoover Commission recommendations.

• SB 1911 (Ortiz) would create a task force to study ways of streamlining public children's mental health programs and improving mental health care for children with private insurance. It would also study the possibility of creating a state Office of Mental Health Prevention Services.
  
  
• AB 1422 (Thomson) would create the California Mental Health Advocacy Commission (MHAC) to promote improved access to mental health services, combat stigma associated with mental illness, and develop training programs for mental health care providers.
  
  
• SB 30 (Chesbro) would create a work group to study ways to restructure public mental health services and to provide enough funds to meet the need.

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Starting early

The Little Hoover Commission report on children's mental health noted that "young children present the greatest opportunity to respond early to risks and prevent the need for mental health services." Despite the severe shortages of programs and trained providers for children under five, the LHC made no specific recommendations for expanding services for young children.

Prop. 10 commissions at the state and county levels, however, have stepped in to fund some efforts to improve mental health programs for young children. In many counties, Prop. 10 commissions are funding mental health consultants for child care programs as well as mental health services for young children. And the state Prop. 10 Commission's Infant Family Mental Health Initiative provides grants for "quality early mental health and relationship-based services for young children, their families, and other primary caregivers."

In Stanislaus County, for example, the county mental health department had already developed the Leaps and Bounds program, providing counseling and case management for families of young children. The emphasis, says Project Director Janette Jameson, is on "treating the parent as an 'expert,' focusing on what the parent does right."

Leaps and Bounds used funds from the state Prop. 10 Commission's Mental Health Initiative to hire three parent-mentors to serve as "peer counselors and advocates for parents," says Jameson. The parent-mentor develops a friendship with parents in the program, offering companionship, guidance, and support.

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Children's mental health resources

• National Action Agenda for Children's Mental Health, U.S. Surgeon General, www.surgeongeneral.gov/cmh
  
  
• Young Hearts and Minds: Making a Commitment to Children's Mental Health, Little Hoover Commission, www.lhc.ca.gov/lhcdir/report161.html, 916-445-2125
  
  
• Building Services and Systems to Support the Healthy Emotional Development of Young Children, National Center for Children in Poverty, 212-304-7100, www.nccp.org, click on "publications"
  
  
• Zero to Three, research and publications on the youngest children, 202-638-1144, www.zerotothree.org

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