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⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Findings and Recommendations 8 findings
F1
The Department of Mental Health provides services for the following populations of young people up to the age of 22: • Children in public schools who are in special education programs and need mental health assistance to be able to continue their education. • Children in the Medi-Cal or Healthy Families insurance programs who are dependents of the county. • Children in the juvenile justice system. • Children from the school special education programs who are classified as severely emotionally disturbed (SED) with a mental impairment and who need very concentrated services. • Any child in an acute emotional crisis who requires immediate emergency assessment and possible hospitalization.
No recommendations for this finding
F2
The Department of Mental Health provides the following services for minors; • In the more restrictive special education programs of the public schools, staff from the Department of Mental Health help evaluate the child’s needs and are part of the team planning the child’s Individual Education Program (IEP). The goal of the IEP is to allow the child to continue his/her education. 2 • Under the mandates of AB 3632 referral, a severely disturbed child is eligible for therapy, counseling, and medication if needed. He/she attends school in a separate dedicated classroom with a staff of trained educators, psychologists, and therapists in attendance. This is an expensive program whose cost is shared by the Department of Mental Health and the Sonoma County Office of Education. • The Department of Mental Health has a grant to treat 30 severely emotionally disturbed children in a very intensive behavior modification program. These children have been assessed as being able to benefit from the program. The staff works with the children in a school setting and with the children’s families. The results from this program are dramatic; these children seldom mature into adults with mental illness, and the improvement in their mental health generally happens very quickly. The State of California is cutting funding for this program. • The Department of Mental Health provides counseling and medication, if needed, for the young people in the juvenile justice system. This program is not funded by the Department of Mental Health but is paid for by the Sonoma County Juvenile Probation Department. • Children who are residents of the Valley of the Moon Children’s home, in foster care or living in group homes, are dependents of the county and are entitled to the services of the Mental Health Department. • All children in acute crisis can be seen at Norton Psychiatric Emergency Services. If they are assessed as needing hospitalization, the department will try to find a bed in a designated hospital outside of the county. Even though the patient may have private insurance, the Department of Mental Health must guarantee payment to the hospital if the patient’s insurance fails to honor the claim.
No recommendations for this finding
F3
The Department of Mental Health is financially dependent on the State of California. It receives 90% of its funds from the state and only 1% from the county. The annual budget for Youth Services is about $12.5 million. By the end of this fiscal year (July 2003) about $3.6 million of that budget is projected to be in arrears. The major loss from the State is the funding suspension for the mandated services (AB3632) for children in special education programs and the lack of reimbursement of 70% for Medi-Cal billing. Since July 1, 2002, health plans and insurers have been required to provide parity in benefits for mental health disorders on the same basis as physical health disorders. However, since this parity was legislated, the percentage of claims paid by private insurers has decreased by 43%. Last year only 4.4% of the $ 2.3 million billed to commercial insurance by the Department of Mental Health was recovered.
No recommendations for this finding
F4
If the funding were adequate, the Department of Mental Health would provide services for every child in the county who needs help. Their wish list includes a hospital for those acutely ill with emotional problems, a program of early intervention and a mobile service unit which could respond very quickly to children in crisis.
No recommendations for this finding
F5
The losses in both current and future funding mean that every child who is mandated to be served will continue to be seen, but the services will be diminished. 3
No recommendations for this finding
F6
The Juvenile Justice Commission reports that the mental health treatment of young people transferring from county detention to a group home is often inadequate at a time of great instability for the child.
No recommendations for this finding
F7
The Department of Mental Health treats about 2400 children a year, of which 470 are labeled as severely emotionally disturbed and receive the most concentrated services In 2002 they saw 300 acutely ill children at the emergency clinic of whom 160 required hospitalization.
No recommendations for this finding
F8
There are many children who do not receive mental health treatment. These include children who do not qualify for any of the services offered by the Department of Mental Health. There are older adolescents who are at risk for suicide or depression whose symptoms may be difficult to recognize. Many families simply do not know where to turn when their children need help. Conclusions Certain defined populations of children receive the benefits of the therapeutic programs of the Department of Mental Health. Special education students with moderate problems get help that allows them to continue their education. Some of the more severely affected students are treated in concentrated programs that can thwart the onset of mental illness. Outside the school system, county dependents or juveniles in detention receive some therapy. All young people can be seen as emergency patients. The early intervention in treatment of severely disturbed children often reduces the development of mental illness. Early treatment is economically sound as well as socially responsible. Children who are not treated sufficiently are more apt to become adults with a long term mental illness than children who do get adequate treatment. Adults with mental illness often add to the problems of homelessness and poverty at a great social and financial cost to the public. There is a large population of young people not covered by these programs. They must find diagnosis and treatment from private therapists or psychiatrists. Yet many of these families have no information about what programs might be available for their child or where to find treatment in the private sector. Often when they need this information, there is a crisis with the child and intervention is needed immediately. The lack of funding for youth services in the Department of Mental Health will damage the programs now in effect and may render the department ineffectual in the near future. Without a more solid fiscal base, plans such as an in-patient hospitalization facility, mobile teams to treat youth in crisis, or early intervention programs will never become a reality. Commendation The Grand Jury commends the Department of Mental Health and the public school system of Sonoma County for their working partnership treating children identified as severely disturbed. Such a partnership is not common throughout the state. 4
Related Recommendations (3)
R1
The Department of Mental Health should oversee the production and distribution of a comprehensive informational brochure for those families in the private sector who do not know where to get help for their disturbed or mentally ill teens or children. A list of resources should include these items; • Professional therapists • Family support groups such as the National Alliance for the Mentally Ill • Patient support groups through Interlink • Peer counseling groups such as the one for pre-suicidal teens called “Reach Out to Someone” • Non-profit agencies such as Social Advocates for Youth, which offer information and telephone numbers for the many teen “Help Hot-Lines”
R2
Sonoma County should subsidize the printing and distribution costs of this informational brochure.
R3
Since the Department of Mental Health is already short-staffed, it is recommended that the department explore the possibility of having a student at the college or graduate level undertake the project as an intern or as a thesis subject or seek community volunteers. Required Responses to Findings Department of Mental Health: F5 and F6 Required Responses to Recommendations Department of Mental Health: R1 and R3 Board of Supervisors: R2 5
Conclusions 1
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CL1 Page 4Certain defined populations of children receive the benefits of the therapeutic programs of the Department of Mental Health. Special education students with moderate problems get help that allows them to continue their education. Some of the more severely affected students are treated in concentrated programs that can thwart the onset of mental illness. Outside the school system, county dependents or juveniles in detention receive some therapy. All young people can be seen as emergency patients. The early intervention in treatment of severely disturbed children often reduces the development of mental illness. Early treatment is economically sound as well as socially responsible. Children who are not treated sufficiently are more apt to become adults with a long term mental illness than children who do get adequate treatment. Adults with mental illness often add to the problems of homelessness and poverty at a great social and financial cost to the public. There is a large population of young people not covered by these programs. They must find diagnosis and treatment from private therapists or psychiatrists. Yet many of these families have no information about what programs might be available for their child or where to find treatment in the private sector. Often when they need this information, there is a crisis with the child and intervention is needed immediately. The lack of funding for youth services in the Department of Mental Health will damage the programs now in effect and may render the department ineffectual in the near future. Without a more solid fiscal base, plans such as an in-patient hospitalization facility, mobile teams to treat youth in crisis, or early intervention programs will never become a reality.
Commendations 1
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CM1 Page 4The Grand Jury commends the Department of Mental Health and the public school system of Sonoma County for their working partnership treating children identified as severely disturbed. Such a partnership is not common throughout the state. 4
No Responses Found 2
Government entities assigned to respond to this report. No response documents have been linked in our database.
Sonoma County Board of Supervisors
Elected County Office