The dangerously deficient state of mental health care for Georgia’s children is unacceptable.
When a psychiatrist tells a state committee on mental health that seeking help for young people in crisis is like navigating “a roadmap through hell,” it should outrage us all.
That was just one of many disturbing points raised in “Children in Crisis,” an investigative series by The Atlanta Journal-Constitution.
The descriptive language is not overblown. It is, at-times, deadly accurate.
While some improvements are underway, much more needs to be done to better care for troubled young people here.
The state’s piecemeal mental health care system is failing to serve the growing number of depressed and suicidal children in Georgia. That holds true regardless of whether these children are covered by private health insurance or government-sponsored plans.
That should be intolerable for a state like ours.
We must do better by our children and their parents who are often desperately trying to seek the best care – too often with poor results.
What do these failings look like in practice?
Children in crisis wait hours, or even days, in emergency rooms for a hospital bed to become available.
And while you might think that the state’s largest pediatric hospitals could help here, they can’t.
Why?
Because they don’t provide inpatient mental health care. For that matter, neither do most general hospitals in our state.
As a result, children are often sent to private psychiatric hospitals designed primarily for adults that may not have programs staffed by doctors and therapists who specialize in working with children.
These private facilities are often far away from children’s homes and strict limitations on parent visitation are common. As you’d expect, such isolation can aggravate existing mental health issues.
For those who may mulishly think all of this is no big deal, that children are resilient and prone to idle whining or threats, the statistics should quickly shove aside such notions.
About one in eight teenagers here say they have “seriously” considered suicide within the last year. Over the last decade, suicides by young Georgians have doubled. And in 2021, at least 119 children and teenagers ended their own lives, according to the Georgia Department of Public Health.
That’s a horribly unacceptable toll; it beseeches all of us to demand that Georgia find better ways to support children in need.
What should be done?
For starters, Georgia needs to push even harder to build on the mental health reform work that’s begun of late at the Gold Dome. This year, lawmakers passed a mental health parity law designed to improve access to a range of behavioral health services.
It should be seen as just a start – a good start, yes, but only a beginning.
Former State Rep. Kevin Tanner, chairman of the state’s Behavioral Health Reform and Innovation Commission, framed the challenge well during a June meeting.
“Now,” he said, “we’re going to make this the decade of mental health reform.”
His sentiment should find widespread support among Georgians. And substantive fixes should start as soon as possible.
It’s an encouraging sign, too, that last month Gov. Brian Kemp named Tanner as the next leader of the state agency serving Georgians with mental illness.
One big lever that state lawmakers control is the amount of payments made to mental health providers. There seems to be widespread agreement that it’s too low.
Economic rules of supply and demand being what they are, low provider reimbursements can help create supply deserts such as we’re seeing in Georgia.
Yes, prudent spending of taxpayer dollars is always wise. But spreadsheet statistics and too-common tales of family tragedies resulting from mental health crises point strongly to the need for more investment.
The new mental health law requires state agencies to collect data, including how Georgia’s payments compare to other states. Tanner told The Atlanta Journal-Constitution that “I would anticipate once that study comes back, we will see the commission push for increases in those reimbursement rates that can benefit everyone in the system.”
But adjusting reimbursements won’t be enough to solve this crisis.
Georgia has too few inpatient beds for treating young people with serious mental health conditions. Neither Children’s Healthcare of Atlanta nor The Children’s Hospital of Georgia, which is part of the Medical College of Georgia in Augusta, have them.
There are also persistent, serious problems at times with the quality of care provided in existing institutions. That points to insufficient regulatory oversight by the Georgia Department of Community Health.
As we uncovered in our “Unprotected” series on senior care facilities, DCH is often too slow to investigate or impose sanctions on care facilities that fall short of acceptable standards.
That should change as mental health reform efforts progress here.
DCH should also be required to be more transparent to Georgians in what it does – or doesn’t do. As one example, the agency’s response to The Atlanta Journal-Constitution’s open records queries has long been abysmal.
Georgians deserve much better insight about an agency charged with helping keep vulnerable people safe.
It’s encouraging that many lawmakers recognize the serious problems.
But it’s time for the Gold Dome – with the support of Georgians – to do more to solve them.
The Editorial Board.
