DCF unveils plan for overhaul of children’s mental health care

Department of Children and Families Commissioner Joette Katz (file photo)

CT Mirror

Department of Children and Families Commissioner Joette Katz (file photo)

A new state blueprint for children’s mental health services recommends standardized screening and enhanced school services, better training for all caregivers and the “pooling” of hundreds of millions in public funds to more effectively finance vital programs.

The Department of Children  and Families unveiled the first draft Friday of a new report due to the General Assembly in October. The document, intended to put forward strategies for a comprehensive overhaul of children’s behavioral health, was ordered by legislators in response to the tragic, December 2012 shooting of 26 children and educators at Sandy Hook Elementary School in Newtown. Public comment on the plan is being sought through Sept. 12.

“A core finding from all input sources is that the children’s mental health services are fragmented, inefficient, and difficult to access for children and families,” the report states.

According to the document, as many as 20 percent of Connecticut’s children, roughly 156,000, have mental health needs that would benefit from treatment. Yet many children lack access in a “highly fragmented” system, the report adds. A child’s insurance status, race, ethnicity, language, geographic location and possible involvement in child welfare or juvenile justice programs can influence or hinder access to care.

The strategic plan insists schools play a more crucial role in the behavioral health care system. “School-based mental health is a key area for expansion . . . ,” the report states, adding that it “should result in substantial overall cost savings through early identification and early intervention.”

Besides recommending periodic standardized screening for all children, the report calls for Connecticut “to expand and finance school-based mental health services,” including adding mental health clinicians to school staffs.

Schools also can play a key role in equalizing access to mental health services throughout Connecticut, and the report recognizes more must be done to improve services for children for whom language is a barrier.

But more screening in the schools and elsewhere can lengthen waiting lists for mental health services that children already face in some regions, the report states. Connecticut must recognize the heavy burden hospital emergency rooms face and try to expand crisis response and treatment services.

The report was developed by a working group that includes DCF administrators, mental health providers, community-based social service providers, educators and families of patients.

“When we listen to families, it is clear they have so much to teach us about how to make further improvements,” DCF Commissioner Joette Katz said. “The key to effectively helping children and families is to gain their full participation and that means we have to respect their expertise.”

This group also focused many of its recommendations on the challenge of financing mental health care. According to Jeffrey Vanderploeg, vice president for mental health initiatives with the Child Health and Development Institute in Farmington and a member of the working group, an estimated $300 million to $400 million  is scattered across the state budget for behavioral health initiatives.

The new blueprint calls for a redesign of all public financing for children’s mental health services under a new system that streamlines eligibility for various programs, enrollment procedures, documentation and services. And though an estimated 70 percent of children are covered by health insurance companies or by self-insured employers, the report called for developing new incentives for insurers to improve coverage for mental health.

Vanderploeg said one of the next steps in this process is a detailed analysis of public financing for mental health. And although nothing is certain at this point, he conceded “it’s possible there may be a need for additional dollars.”

But DCF Administrator Kristina Stevens, who heads the division of clinical and community consultation, added that the legislature’s directive was to develop and implement a strategic overhaul over the next five years. Even if there are added costs, she said, there probably would be time to phase many of them in gradually. Other recommendations in the first draft of the report include:

  • Strengthen connections between pediatricians and mental health care providers.
  • Build a mental health data collection network that relies on uniform reporting and analysis to give care providers more information.
  • Develop better training to ensure that all caregivers can recognize risk factors and connect children to all resources.
  • And give family members a greater role in oversight of Connecticut’s behavioral health system for children.

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