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Mental Illness Sends Many to Foster Care

Medical Costs Overwhelm Va. Parents

By Chris L. Jenkins
Washington Post Staff Writer
Monday, November 29, 2004; Page B01

RICHMOND -- Almost one of every four children in Virginia's foster care system is there because parents want the child to have mental health treatment, a report commissioned by the General Assembly states.

The study -- the result of a months-long examination of the state's foster care and mental health services -- chronicles the difficult decisions that thousands of Virginia parents have made to relinquish custody of their children to the foster care system so they can get mental health services that are otherwise unavailable or unaffordable.

Many of these parents have children who suffer from schizophrenia, severe depression or bipolar disorder. The cost of caring for these severe conditions is so high that private insurers and HMOs don't fully cover it, and in many cases, the families make too much money to be eligible for Medicaid.

But because children can get those services if they are in foster care or in special education programs, parents turn to the child welfare system, which can provide day treatment, residential care and other expensive services.

"The main problem is that there is inadequate access to mental health treatment . . . and it tends to be extremely expensive if parents are able to receive it," said Raymond R. Ratke, deputy commissioner of the state's Department of Mental Health, Mental Retardation and Substance Abuse Services, who led the work group that published the report.

State and local officials have known about the problem for years, but the report is the first time Virginia has tried to determine its extent. In the 2004 legislative session, lawmakers passed a resolution impelling state officials to study the issue. A work group was established, and it met seven times during the summer and fall.

The report, published this month, is based on an analysis of the Department of Social Services database, which offers partial information on how children come into foster care. It found that of the 8,702 children in foster care as of June 1, "2,008 . . . appear to be in custody to obtain treatment."

In many cases, the report says, parents develop "a sense of having failed, and feelings of losing control over their own and their children's lives."

The report's recommendations to the General Assembly include increasing funding for the Comprehensive Services Act, which is designed to provide money for mental health services for children, and helping families access private insurance for mental health services.

The state estimates that 62,000 young people suffering from mental illness, behavioral disorders and emotional problems are not being served adequately by the commonwealth.

State lawmakers who have studied the issue say they will push for an immediate infusion of funding for the Comprehensive Services Act, which spent $235.5 million in fiscal 2003 for mental health services.

"This indicates a tragedy for many families," said Sen. William C. Mims (R-Loudoun), who is considering legislation that would add money to the state's mental health system.

"It's the law of unintended consequences," Mims added. "But the state has fallen short. These parents don't do it for convenience. They do it out of necessity . . . and it's unacceptable."

Advocates for the mentally ill say that other states and the District also struggle with funding mental health services for children and wonder how to stem the tide of children placed into foster care solely to get help.

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