Indiana: Lake County pilots new state treatment program

Rescuing kids earlier from mental anguish

Lake County is leading a new statewide initiative to earlier identify and treat children suffering from mental health or addiction problems.

On Jan. 1, Child Protective Services case workers in all Hoosier counties began a standardized testing program to screen children coming into the state's juvenile welfare system — either from abuse, neglect, broken homes or their parents voluntarily relinquishing guardianship. Lake County and eight other pilot counties began the program in July with money from the Indiana Juvenile Justice Institute. Since then, Lake County has screened 92 children coming into the system, of which 37 were flagged as positive for some sort of mental health or addiction problem. Before the program began, not every child was screened in such a formal, systematic way, said Bruce Hillman, director of Lake County's Division of Child and Family Services. Telling parents their child needs mental health services, however, can be an obstacle with the program because it is not something parents want to hear, he said.

Another benefit — saving taxpayer dollars
Nationally, an estimated four out of five youngsters coming into the welfare system have either developmental, emotional or behavioral problems, and only 20 percent of them receive needed mental health services, according to federal data. “Early screening can help address mental health concerns before it's too late,” said Bill Stanczykiewicz, president of the Indiana Youth Institute.
The state's goal: To find treatment for children who show early signs of mental illness — like depression, attention deficit disorder, autism or bipolar disorder — that may lead to dangerous complications or possibly suicide, the third leading cause of death among young adults. For these youngsters, mental health services are repeatedly identified as their primary health need, state officials said.
“Another goal is to save taxpayer dollars, from avoiding duplication of services,” said Tim Thomas, of Edgewater Systems for Balanced Living in Gary. Edgewater is one of a handful of local mental health centers partnering with Hillman's staff to identify and treat those in need. Other centers involved are in East Chicago, Merrillville, Schererville and Valparaiso. Since the program began in July, Thomas' staff has worked directly with 13 children who screened positive and went into counseling or were put on medication “only as a last resort,” Thomas said.

A typical case
In 2003, Lake County saw 338 youngsters come into the system, and Porter County saw 51, giving local case workers an idea of how many cases they may deal with in 2005. The program is implemented when a child age 3 to 18 comes into the state welfare system. First, the child is given a standardized mental health screening — Child and Adolescent Needs and Strengths — by a case worker looking for any early signs of problems. If screened as positive, the child is referred to a local mental health agency for further screening and evaluation, including school records, family history, I.Q. and signs of abuse or self-abuse. That agency offers a recommendation for possible treatment to Child Protective Services, which chooses, if necessary, a mental health agency to treat the child and what services are needed. The child is treated, typically through therapy and sometimes with medication, hopefully with the involvement of family members. The average length of treatment is about nine months, Thomas said.

Other region counties jumping aboard
Porter County, which rolled out the new program Nov. 15, is partnering with Porter-Starke Services, though not exclusively, said Jon Rutkowski, director of the Porter County Office of Family and Children.
While too early to gather numbers, the screenings allow staff a “jump start” in helping the kids, he said.
The Illinois Department of Children and Family Services also is starting a series of 2005 reforms, similar to Indiana's. One is called Integrated Assessment, which partners with local universities and hospitals to provide expertise, including mental screenings. “This approach represents a front door to the child welfare system that never existed before in Illinois,” Department of Children and Family Services Director Bryan Samuels said. Still, some parents in either state can't afford mental health services for their children, so they painfully give them up as wards of the state to receive treatment, said David Roos, Indiana's project director for Covering Kids & Families.
“They feel they have no choice,” he said.
Medicaid is the primary cash cow for Indiana's program, reimbursing local health centers and paying for transportation to treatment.
Roos said this program touches on two broader issues: the restructuring of the state's beleaguered Family and Social Services Administration and the new awareness that children should be screened earlier for signs of mental health anguish. “It's finally a step in the right direction,” Roos said.

Jerry Davich
15 January 2005

http://www.thetimesonline.com/articles/2005/01/15/news/lake_county/9448dff2203f74f086256f8a0005f68a.txt

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