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Some children come to school hungry. They cannot concentrate. Consequently they act out. A teacher has to deal with that. If there were a counselor available, the teacher could refer that child to a counselor; and the counselor could develop a case management plan to help that child rather than allowing that child to be suspended or to fall out or to drop out of school.
[Page: H6580] GPO's PDF
So I am very proud to be with the gentlewoman tonight. I thank her for this. I am in full support of her bill, which is such an important bill, The Give a Kid a Chance Omnibus Mental Heal th Serv ices Act for Children. I think that is a great title for the bill.
It will really forge a critical link in our health netw ork. It also will boost badly needed resources for communities to develop community mental heal th prog rams for children and adults, the same thing that we tried to do in Berkeley, California, in the early 1970s.
So here we are again. We need mental heal th prof essionals in every school. We need our families and children to know that it is okay to seek a counselor and to seek a mental heal th prof essional, and we need to give our kids a chance.
Ms. JACKSON-LEE of Texas. The gentlewoman has highlighted so many important points I do not know where to start, but having just finished the fight to assist the world in its fight for HIV/AIDS, does the gentlewoman not think that if we discover that we have a surplus that was unexpected that it would not be fiscally irresponsible to be able to look at mental heal th pari ty in o ur HMO coverage? The gentlewoman being a psychiatric social worker has seen the pain of people suffering from mental ill ness and mental heal th need s, as I have called it. What I have seen is people who are isolated and do not know where to go.
Let me cite these numbers for a moment. It is estimated between 118,700 and 186,600 youth were involved in the juvenile justice system, I call it the juvenile crime justice system, have at least one mental diso rder. So they really needed other kinds of help.
According to a 1994 OJJDP study of juveniles' response to health scre ening conducted at the Mission of Juvenile Facilities, 73 percent of juveniles reported having mental heal th prob lems and 57 percent reported having prior mental heal th trea tment. Of the 100,000 teenagers in juvenile detention, estimates indicate that 60 percent have behavioral, mental, or emotional problems.
Is it important that we try to find the funding to be able to help not only these children but these families? And I know social workers are not paid what they should be paid.
Ms. LEE. Or psychiatrists or psychologists.
Ms. JACKSON-LEE of Texas. Or child psychiatrists.
Ms. LEE. Mental heal th prof essionals need to be paid what they deserve to be paid, and based on their workload they need to be paid twice as much.
Let me just say that one has to believe that the mind and the body are equally important. I think all of us believe that, but we have not put our money where our mouth is.
Mental heal th pari ty is c ritical if one believes that one's spirit, one's mind is just as important as the physical body. Psychosis, schizophrenia, depression, all of these mental issu es, and I will not call it mental illn ess either because we still do not have a clear definition of mental illn ess, but all of these behavioral difficulties can be cured in many instances.
So why do we not elevate the mind and the body on an equal basis, because certainly one cannot be treated without treating the other? So additional resources making mental heal th poli cy as part of our national health poli cy should really be a national priority, and we should use some of our surplus to do just that.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the gentlewoman from California (Ms. LEE) very much. I thank her for her work before coming to Congress, her work now. Let us commit ourselves, first of all, to the reality that this Nation is suffering from inadequate mental heal th serv ices.
Yes, they are there in spotty places throughout the Nation, but even the community mental heal th serv ices or the community mental heal th cent ers are only in about 37 of our States. The funding does not allow for complete use in all 50 States.
More teenagers die from suicide, Mr. Speaker, than from cancer, heart disease, AIDS, birth defects, strokes, influenza and chronic lung disease combined.
The U.S. Surgeon General stresses that mental heal th need s should be a central part of this Nation's health poli cy debate because mental heal th is i ndispensable to personal well-being, family interpersonal relationships, and contribution to community and society. I think when we talk about our children, families know about anorexia nervosa, we know about that. We have heard about anxiety disorders, but are we aware that our children suffer greatly from depression?
If I might share as I close this evening, depression is one
of the most treatable mental illn
esses as it is said here on the National Mental Heal th Asso ciation fact sheet, but early
diagnosis and treatment are essential to depressed children and can help them
lead to better long-term good health. I want to applaud some of the great works of some Members
of our Congress, both Republicans and Democrats, but we need to finish the job.
The job means that we have to find good resources for children so that they can
grow up to be healthy adults.
Let me acknowledge Dr. James Comer, who is here with the
Yale University Child Study Center, been a leading force on children's
mental heal th; Dr. Koplewicz, from the New York
University Child Study Center who has also been working, but they need us in the
United States Congress to fund legislation. I hope that H.R. 3455, give a kid a
chance legislation, that asks for just $100 million to be able to put school
counselors and nurses in schools, to be able to help our children find their way
and to help their parents, would be considered in this Congress.
I do hope that those who feel isolated with the impact of
mental illn ess in their families
will find a way to believe in the United States Congress that we are moving
toward addressing this question and not leaving them to suffer alone, Mr.
Speaker.
NEEDS OF MENTALLY ILL CHILDREN IN THE JUVENILE JUSTICE
SYSTEM POSITION PAPER
MENTAL HEAL
TH MENT AL RETA RDATION AUTHORITY OF HARRIS
COUNTY
Over the years, the MHMRA Child and Adolescent Services
Division, operating with limited resources, has been able to serve the needs of
a variety of juvenile offenders through their outpatient clinics, school-based
programs and day treatment services. However, it is apparent that there is a
growing number of juveniles who are dually diagnosed whose needs cannot be met
in our current county institutions.
Data collected by the Forensic unit on juvenile offenders
indicate 17% of these youth (one of every five) suffer from a severe mental condi tion characterized by disturbed
thinking, mood disorder, or impulse control disorder. When we include children
who are diagnosed with Conduct Disorder, this percentage increases to 33% (two
out of every five). Yet, the juvenile justice system does not have a single
facility for mentally ill offenders. At present time, the Juvenile Probation
Department sends children with severe mental health proble ms to private placement. This has
resulted in the unprecedented amount of money spent in private placement. Within
the last year, the collaboration between MHMRA and the juvenile probation
department has resulted in the provision of some psychiatric services at
juvenile probation facilities. However, this does not begin to address the needs
of mentally ill children.
Mentally ill children are more vulnerable to drug and
alcohol problems, and are at high risk for suicide and for committing
non-rational violent acts. While we can not completely divert these children
from the juvenile justice system because their condition is manifested in
serious behavioral problems, for the majority of these children, an improvement
in their condition equals an improvement in their behavior.
In order to address the needs of these mentally ill
children, we need specialized programs that emphasize psychological/psychiatric
intervention and that are manned by professionals with training in dealing with
these children. These specialized services should be available in a continuum of
care that addresses all levels of severity, and can either be contracted out or
provided through MHMRA and Juvenile Probation with additional funding. Some of
these specialized services/needs are described below.
Because of the severity of behavior problems, many of the
most seriously mentally ill children are held in the detention center either
awaiting court or awaiting placement. This is particularly detrimental for these
children because of their limited cognitive and emotional resources.
Consequently, their
Chronically mentally ill children who are adjudicated
delinquent and who, as a result of their condition, are prone to aggressive
outbursts and whose behavior is so impaired that they represent a substantial
risk to themselves or others, will necessitate a long term Residential Treatment
Placement. The focus of this placement will be to provide regular
psychiatric/psychological interventions in the form of individual, group, and
family counseling, as well as medication interventions. It will also be
important to incorporate an aftercare program that includes a transition to a
less restricted facility prior to return to home placement.
No one agency should be responsible for providing services
for these children. The needs of these children are complex and, as a result,
need the efforts of all local agencies including Juvenile Probation Department,
MHMRA, Child Protective Services, and the local school district.
Recommendations: It is imperative that Harris County have a
centralized data bank, so that all the different agencies have immediate access
to information regarding performance and participation in school program,
history of mental illnes
s/condition, history of referrals to the Juvenile Probation Department, and
information regarding physical or sexual abuse or foster placement. The lack of
this information makes it difficult to recognize the needs of children and offer
appropriate alternatives.
Need for Research: It is imperative to have research driven
treatment alternatives. To this end a centralized data source would be helpful.
In Harris county, this would involve having a data system that includes the
HCJS, MHMRA, CPS, and HISD, so that children can be easily identified, and to
allow for continuation of services.
Training of Practitioners: Government should sponsor
internship/resident programs with local universities or institutions of higher
learning to allow for a rotation with these mentally ill children. This would
serve the purpose of educating professionals who will be going into positions of
responsibility with regards to these children, and/or to provide a larger pool
of professionals with training with this specialized population.
Training of Juvenile Court Staff: It is imperative that all
levels of court personnel (judges, district attorney, juvenile attorneys) and
Juvenile Probation staff have an understanding of how mental illnes s or level of functioning can be
a factor in criminal activity. Training in the complex issues of competency
should be mandatory.
Legal System: Courts must continue to be involved because
these children do have severe behavioral problems that put the public at risk,
but also because in many instances it is the threat of legal action that
motivates families and youth to participate in many of these programs.
Therefore, they should have ultimate authority to remove these children from
participation in these specialized programs should there be no indication that
they are making an impact on the youth and/or the family. In making these
decisions it will be important that those more closely involved with the
implementation of these programs should receive education regarding mental illnes s so that they can make better
decisions regarding the alternatives for these children.
Federal Funding: There is no doubt that implementation of
the above recommendations is a costly endeavor. Support at the federal level in
the way of legislation that provides line item funding for these services is
recommended.
Mr. Speaker, children's mental health needs to be a national priority in this
country today!
In this nation, we have taken great strides to address
spend 10 times the amount on research into childhood cancer, than on children's
mental health , yet o ne of five children is affected
by some sort of mental illnes s.
Even more devastating is the fact that although one in five
children and adolescents has a diagnosable mental, emoti onal, or behavioral problem that
can lead to school failure, substance abuse, violence or suicide, 75 to 80
percent of these children do not receive any services in the form of specialty
treatment or some form of mental health interv ention.
This heartbreaking story of Kip Kinkle, the fifteen
year-old student of Springfield, Oregon, who shot his parents and went to school
to kill several other students is tragic, yet illuminating.
For three years before this horrendous event, Kip suffered
from psychosis and heard voices, yet no one did anything to address this
situation. No teacher sent him to the nurse and no one asked his parents to take
him to a doctor to find out what was wrong.
This is why I stand before you today to encourage my
Colleagues to address the inadequate funding for comprehensive children's mental
health servic es. We need to reach these 75 to
80 percent of children suffering from mental illnes s and not allow any more days to
go by, otherwise we are waiting for another school tragedy like Kip Kinkle to
occur.
The recent Surgeon General's Report on Children's Mental
Health specif ically states that ``most
children in need of mental health
servic es do not get them ..... ''
Hence, when children's mental health needs are not met, young people often
get caught in child protective services or the juvenile justice system. As a
result, we see that almost 60 percent of teenagers in juvenile detention have
behavioral, mental or emo tional
disorders.
Although children's mental health servic es were funded at the President's
request under H.R. 4577, this funding was still below the requested funding by
National Mental health Associ ation and the Federation of
Families for Children's Mental Health Servic es. In order to adequately fund
children's mental health servic es, we would need to fund this
program with at least $93 million and not the $86 million allocated in the
poorly funded bill H.R. 4577.
Currently, the Children's Mental Health Servic es Program only serves
approximately 34,000 children.
Additional funding would enable more states to provide more
mental health servic es on the community level.
This is why I attempted to offer an amendment to H.R. 4577
to increase the funding for the Substance Abuse and Mental Health Servic es Administration by $10 million
dollars. The intent of this Amendment was to increase the funding for the
Children's Mental Health Servic es Program under SAMSHA.
Both the National Mental Health Associ ation and the Federation of
Families for Children's Mental Health Servic es support increased funding for
children's mental health and ag ree that we need to focus this
nation's attention on intervention measures so that we can prevent tragedies
like Columbine in Littleton, Colorado, Heath High School in Paducah, Kentucky,
and Westside Middle School in Jonesboro, Arkansas.
The grant programs funded under the comprehensive community
mental health servic es program are critical to insure
that children with mental health
proble ms and their families have
access to a full array of quality and appropriate care in their communities. To
date, there have not been sufficient funds to award grants to communities in all
the states.
It is also crucial that we emphasize the fact that mental
health disord ers often lead to teen suicide
with a person under the age of 25 committing suicide every 1 hour and 57
minutes! The fact that 8 out of 10 suicidal persons give some sign of their
intentions also begs the question, why do we not make children's mental health a nati onal priority.
We know that more teenagers died from suicide than from
cancer, heart disease, AIDS, birth defects, strokes, influenza and chronic lung
disease combined.
Because childhood depression is so very prevalent, we must
recognize the dire need for increased services to treat our youth.
One of the unfortunate realities of the lack of mental
health servic es is the fact that many
juveniles convicted in the criminal justice system are in the system because
they need mental health servic es. Recently, the Human Rights
Watch released its year 2000 report entitled, ``Punishment and Prejudice: Racial
Disparities in the War on Drugs.'' This report detailing the discrepancies
between criminal sentencing of African-American and Hispanic drug offenders
versus White drug offenders in the juvenile justice system. This report also
makes reference to the failure of minority youth to be provided adequate mental
health servic es or appropriately sentenced
according to their mental health
needs.
Additionally, the New York Times released a study this past
March that was conducted on 100 rampage killings. This Report indicated that
mental health servic es could help prevent future
outbreaks of violence among our youth and save students and their parents from
the torture of another school shooting.
This is further support for the belief that all children
need access to mental health servic es. Whether these services are
provided in a private therapy session or in a group setting in community health
clinic s, private sessions or
through the schools, we need to make these services available. That is why this
Congress should support legislation that will help remedy the lack of mental
health servic es in the school system.
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