Audit cites flaws in Georgia’s mental system for youths

The state of Georgia lacks sufficient documentation about the mental health care it provides to thousands of children and adolescents, according to a new report.

The report, released by the Georgia Department of Audits and Accounts this week, finds several deficiencies in the state’s tracking of mental health services for uninsured children and those eligible for Medicaid coverage.

The Department of Human Resources, which runs the public mental health system, “lacks a systematic process for determining the most critical needs for the child and adolescent population,” the audit said.

Because of that deficiency, the state can’t be sure whether it’s treating the children most in need of mental health services such as counseling, said Sue Smith, CEO of an advocacy group, the Georgia Parent Support Network, who reviewed the findings Wednesday.

The audit of children’s care provides another critical evaluation of Georgia’s troubled mental health system.

Last week, the state reached an agreement with the Department of Justice to make major improvements in its state psychiatric hospitals — and to spend what’s necessary to protect patients from harm. Federal investigators last year concluded that the hospitals’ failure to address critical errors caused unnecessary deaths and injuries.

The Justice Department investigation was prompted by articles in The Atlanta Journal-Constitution, which found at least 136 suspicious deaths of hospital patients and almost 200 confirmed cases of patient abuse from 2002 through late 2007.

Gov. Sonny Perdue has proposed putting mental health services into a separate state agency.

The Department of Human Resources said Wednesday that it disagreed with some of the criticisms in the report, which focused on children’s services offered in communities across Georgia.

Mental health services are provmided by different agencies and have several sources of funding, creating a complex system, said Gwen Skinner, director of the state’s mental health division. In addition, recent program changes have added to that complexity, making it difficult to evaluate, she said.

“Recent DHR performance management activities have been successful in reducing state hospital utilization and improving behavioral health services to youth in DFCS custody,” DHR added in its response to the audit.

Input from regional mental health boards often is ignored in DHR decision-making, the audit said.

The audit also noted that, according to DHR, there was a decrease in youths who experienced improved functioning through care between fiscal 2006 and 2008.

The report also cited inadequate financial documentation within DHR. “We’re looking at our internal [financial] processes,” Skinner said.

Smith, whose Georgia Parent Support Network advocates for children and their families, said, “The system seems uncoordinated and lacks accountability.”