In an effort that grew out of personal experience, advice from experts and the stories parents told in the wake of the massacre at Sandy Hook Elementary School, the head of the legislature’s Committee on Children Monday unveiled a proposal aimed at making it easier for families to access mental health services for children.

The bill is a first step, a framework for the mental health system, Sen. Dante Bartolomeo, a freshman Democrat from Meriden, said as she outlined the measure, flanked by mental health experts and parents of those killed at the Newtown school.

Advocates for mental health and early childhood programs offered a similar assessment. The bill doesn’t require spending any state money — an advantage for the measure’s chances in a tight budget year, but also something that leaves it short of fulfilling all of the advocates’ wishes.

Despite the lack of state funds, Bartolomeo said the proposal could improve the fragmented mental health system, and would position Connecticut well to receive federal funds.

“What we are requiring here is communication and cooperation,” she said.

The proposal includes requiring formal coordination between mental health agencies, schools and emergency mobile psychiatric services. It also calls for a coordinated system of home visitation programs that serve vulnerable families of young children. Experts consider such programs key resources for preventing problems and intervening early.

The bill also calls for increased training in mental health and child development for pediatricians and child care providers, and training for mental health providers in understanding and treating trauma. Research indicates that trauma is a major contributor to mental illness, and that prompt treatment can prevent long-term negative effects. But often, children experiencing the effects of trauma are misdiagnosed and receive ineffective treatment.

There would be a public information campaign about children’s mental health — if private funds are available to pay for it — and a task force on the effects of nutrition, genetics, toxins, psychotropic drugs and complementary and alternative treatments on the mental health of children. Programs that currently get public funding for mental health of children would have to report annually on how easy or difficult it is to access treatment.

Two other provisions relate to juvenile justice, with the goal of ensuring that children with mental health needs are getting help, rather than entering the correction system. School resource officers would be required to get training in best practices to ensure that children with mental health needs aren’t victimized or disproportionately referred to the juvenile justice system, although the training would be contingent on federal funding. And, if the judicial branch secures the money, there would be a study of whether children and young adults who need mental health treatment are instead entering the juvenile justice and correction systems.  

“This is critical legislation,” said Dr. Darcy Lowell, a developmental and behavioral pediatrician and CEO of the highly regarded home visiting program Child FIRST, which includes psychotherapy for very young children and their caregivers. “It makes clear that the most effective way to stop this epidemic of mental health problems is to find children at the earliest possible time.”

Lowell described the results of research on brain development, which show that exposure to violence, trauma, maternal depression, abuse, neglect, homelessness, or substance abuse can lead to chemical changes in very young children’s brains, with lifelong effects. “It is as poisonous as lead, as poisonous as alcohol to the young brain,” she said. “We have to do something about this.”

It’s critical, she added, for child care providers, pediatricians and social workers who work with children to know how to identify problems in children and how to access services.

Nelba Marquez-Greene, a licensed marriage and family therapist whose daughter, Ana Grace, was killed at Sandy Hook Elementary, spoke of spending the past five months grieving for her daughter, raising her surviving son, and meeting with mental health providers and parents of children who need mental health treatment.

On the day of the Sandy Hook massacre, Marquez-Greene said, “All of the problems in our mental health system that I knew existed intellectually, and that I’d seen in my professional life, manifested themselves in the most personal and tragic way.”

She described the bill as the start of an effort to address children’s mental health.

“I hope this is the beginning of a long overdue effort to increase access to mental health treatment in all towns across our state, and reduce what can be a debilitating stigma that goes along with seeking help,” she said.

Jennifer Maksel, whose youngest son escaped the shooter at Sandy Hook, detailed the struggle she faced in getting her older son help. She knew something was wrong when he was 2, but their pediatrician told her, “I hate behavior questions” and didn’t tell her about an early childhood program that could have helped. Over the years she’s had to fight the state, schools, insurers and hospitals to get her son care.

“I am so tired of fighting,” she said. “No parent should have to fight for a decade to get her son the medical care that he needs.”

Her son didn’t really start getting help, Maksel added, until she testified about him at the state Capitol complex in February as part of a hearing on mental health issues inspired by the Sandy Hook shooting.

But now Maksel said she faces another challenge: Her youngest son saw his teachers and best friends murdered, and getting him the help he needs has been another fight.

Like others, Maksel said she hoped the bill would be a first step toward making sure kids get the medical care they need.

“My family knows first-hand the enormous cost of continued inaction, and no family should have to pay that price,” she said.

Bartolomeo said the issue is personal to her, too: Her sister was a victim of severe childhood trauma before being adopted into the senator’s family, and was in and out of treatment programs for 16 years. Bartolomeo said her mother described getting involved with the system as “like stepping into a foreign country without knowing the language or the customs.”

“During times when it felt nearly impossible just to survive, they had to learn how to navigate the system, to do their own research to find available services, to act as liaisons between treaters, to piece together a comprehensive continuum of care, to fight with insurance companies which didn’t want to live up to their promises of coverage, and to still be there to support the rest of us, the rest of their family,” she said.

That, she added, inspired her to propose language that would begin to make the mental health system focus on prevention, early identification and intervention, one that offers support in a continuum of care. 

Several of the recommendations reflected suggestions from a group of experts and advocates for mental health, health care and child development, said Judith Meyers, president and CEO of the Child Health and Development Institute of Connecticut.

The lack of funding is a concern, she said.

“But at least it’s a call to action,” Meyers said.

Arielle Levin Becker covered health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on caregivers from the National Association of Health Journalists. She is a 2004 graduate of Yale University.

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