Petula Dvorak
Petula Dvorak
Columnist

Safety nets for mentally ill children are full of holes

For 55 days now, no one has come for the boy.

In a courtroom miles away, people argue over what should happen to the 10-year-old Prince George’s child whose mom drove him to a D.C. hospital, checked him in and left him there.

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Psychotherapists, teachers and social workers visit him every day. He has games, books and a television but no window in the psychiatric ward where he is being kept.

An abandoned child is a sign of utter desperation and, often, systemic dysfunction. It’s not just about one broken family or a single, troubled child; it’s about crippling bureaucracy, impotent policy, lack of education and money, money, money.

This boy’s situation is a scenario that plays out at hospitals all over the country every day. Hospitals have become dumping grounds for families of children with mental illness and nowhere else to turn for help.

“It’s a nationwide problem,” said Paramjit Joshi, director of psychiatry at Children’s National Medical Center, where the 10-year-old has been languishing since Sept. 15.

His future has become a hot potato being tossed around among social service agency attorneys, hospital attorneys and his mother, who says she is unable to care for him.

And that’s not a surprise, given what the hospital knows about the boy.

He has received diagnoses of attention deficit hyperactivity disorder, manic depression and bipolar disorder, according to court papers and reports by The Washington Post’s Keith Alexander.

He was suspended from school in August and threatened to commit suicide. He stabbed a relative in the eye with a pencil and told doctors that he found hurting people “funny,” according to court records.

The mother did what she had done before when her child was dangerous and unmanageable — she drove from Maryland into the District and checked him in at Children’s. Only this time, she didn’t pick him up.

Since then, the child’s case has gone to court.

Attorneys for Children’s say their facility is an acute-care hospital, not a permanent home for an abandoned boy. They want someone to take him. At one point, hospital attorneys even suggested that an ambulance drop him at the social services department in Prince George’s County.

But county attorneys said Prince George’s doesn’t have the facilities to treat him.

So how about D.C.? Nope, his mom’s not a resident.

“Even if he lived in D.C., the sad reality is that D.C. does not have a functioning children’s mental health system,” said Judith Sandalow, executive director of the D.C. Children’s Law Center, which deals with cases like this one and is representing the boy’s mother. “There is a dearth of children’s mental health services in the District. And this situation is not unusual, sadly.”

Recently, the center dealt with a 15-year-old who came into the office in a wheelchair because he’d been shot when he was 11, among many other traumas in his life. This child had never once been screened for a possible mental health issue, Sandalow said.

In the 10-year-old’s case, the mother appears to be aware of her lack of ability to care for her child without support. She tried other avenues, checked him into Children’s when it got dangerous, then finally gave up.

Dad, on the other hand, says that he wants to take the child home but that he doesn’t have custody and has been out of the boy’s life for some time. He also has a small child in his home, who could be in danger with a mentally ill older child in the house.

After D.C. Superior Court Senior Judge Eugene N. Hamilton ordered someone to take the child and “stop this merry-go-round,” the boy appeared to be headed to a facility in Philadelphia that could handle him. That move is on hold until another hearing this week.

The child was clearly in peril long before Sept. 15. And 55 days in a hospital, abandoned and alone, won’t help him, no matter how good the doctors there are.

“Child time is not adult time. Seven days, two weeks, three weeks — that’s a lifetime for a child anywhere, especially a child with mental health issues,” Sandalow said.

We have all kinds of safety nets in place to ensure that children are able to get vaccinations, annual doctor visits and cold medicine. Yet mental health, in most cases, is an afterthought.

This despite the fact that one in five children has a diagnosable mental disorder and one in 10 has mental health problems severe enough to impair how they function at home, in school or in the community, according to a recent report by the National Center for Children in Poverty.

“That means that in a class of 100, you have at least five kids” who have mental health issues, Joshi said.

“It’s so important to identify [mental illness] at an early age,” she said, and get those children treatment.

But the reality is that cash-strapped governments aren’t carving out a lot of extra cash these days for this kind of care.

Then again, maybe some counseling upfront would have kept the boy at Children’s off this costly merry-go-round.

E-mail me at dvorakp@washpost.com.

 
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