Improving Kentucky’s mental health calls for the action of schools and doctors to identify children’s mental health needs early

people may think that addressing mental health needs in Kentucky relies mostly on more funding, but its effectiveness hinges more on the ability to identify children who need help and make sure they get it
early, two experts said on cn|2‘s “Pure Politics” Tuesday.

About half of mental illnesses begin to appear before a person turns 14, reports cn|2’s Ryan Alessi. Mental-health experts say it’s often more effective and efficient to treat children, and it’s easier for parents to make sure their children get help than it is for
someone to convince or coerce an adult exhibiting symptoms that he needs
treatment, said Dr. Allen Brenzel, a child psychiatrist.

Encouraging school officials and doctors to identify children with these needs can be a challenge, Brenzel said, because it is difficult for a teacher to have tough conversations with parents about this topic. Also, while doctors may be most important in this process, obstacles exist because our current “system of care doesn’t promote the amount of time and effort and importance on these issues,” he said.

When a primary-care doctor’s offices are jammed with sick patients and a parent comes in to discuss problems their child is having in school, “That’s a challenging environment in primary care,” Brenzel said. “But people trust their primary care providers very often, and that is where they go. So some of what we need to look at is co-location of services.”

Brenzel said we need a system with a single point of access, where a family can be greeted, there is a period of engagement and a reimbursement structure that supports the time and efforts required by behavioral health.

“We need to integrate behavioral health into the overall health care system,” he said. “We have a very fragmented and inefficient system that leads to confusion when a family identifies that their child needs help and this isn’t going to be fixed by a medical model.  We now know that the kinds of services need to be much more comprehensive and supportive. A system that allows a comprehensive mental and behavioral health assessment of needs will allow us to triage many kids out of the juvenile justice system.”

Benzel said this is a societal issue and for every $1 that we spend in supportive services, we can avoid spend $5 later on adult incarcerations and adult prison. On average, it was more than $2,000 cheaper per person to treat a child than an adult. It amounted to $4,328 per child compared to more than $6,500 for each adult treated, Alessi reports.

Families may be fearful of the cost of mental-health services, but there are resources for people without mental-health insurance coverage at the 14 mental health centers in Kentucky, said Steve Shannon, executive director of the Kentucky Association of Mental Health/Mental Retardation Programs.

In terms of resources, Kentucky spent nearly a half billion dollars on mental health for people under 21 in the 2010-11 fiscal year. For adults, the state spent more than $730 million, according to figures from the Cabinet for Health and Family Services. (Read more)

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