January 11, 2012

A YEAR AGO, Virginia Gov. Robert F. McDonnell (R) proposed slashing millions of dollars from the state’s already badly fragmented and underfunded programs for at-risk children and teenagers. The cuts targeted funding for specially trained foster families and other services for children, including some who posed a danger of violence to themselves and others. The cuts were rejected, and funding restored, thanks to a bipartisan group of lawmakers responding to an outcry from advocacy groups and local governments, which would have borne the brunt of the governor’s proposal. In the end, the debate turned a useful spotlight on a critical hole in the state’s social services safety net.

In the biennial budget he has just proposed, Mr. McDonnell made no similar run at mental health services for children. But if last year’s tangle showed anything, it was that maintaining even the status quo is itself a risk, given the severe shortcomings in services offered by the state, which have been compounded by deep cuts in funding by localities. Fairfax County, for example, has cut about 10 percent from its main mental health agency’s $150 million budget since 2008.

Funding for troubled children and teenagers has long been meager compared to similar (and still modest) programs for adults, whose mental health problems are better recognized by lawmakers. After the 2007 massacre at Virginia Tech, the state’s mental health system for adults was revamped and received new funding. But public programs for children and teenagers were more or less ignored, despite drastic state underfunding.

An estimated 1 in 5 U.S. children suffers a mental health disorder; of that population, only a fifth get the services and treatment they need, experts say. In practice, that means many Virginia parents, even in wealthy jurisdictions like Fairfax, find it difficult and often impossible to get prompt and adequate attention for teenagers and children who exhibit danger signs until a full-blown crisis erupts.

Even then, the options can be maddeningly limited for out-of-control kids. That’s especially true for families hoping to find treatment and support in the community and thus avoid the trauma and dislocation of a psychiatric hospital far from home.

Advocates for troubled youths and their families are seeking a modest fix that would mark an enormous improvement in the state’s spotty services. A coalition of groups called the Campaign for Children’s Mental Health has proposed that the state establish small, rapid-response teams, including psychiatrists and clinicians who would provide prevention techniques along with treatment. The teams could quickly intervene in crises at homes, schools or juvenile jails — in some cases offering short-term stays in small stabilization units — that could defuse volatile situations before youngsters require expensive hospitalizations.

The cost and scope of such a program, estimated by advocates at less than $20 million, is obviously subject to negotiation in what is sure to be a tough budget year in Richmond. But it’s clearly a proposal that merits a serious hearing.