Following years of negative reports that found the District wasn’t reaching enough of the city’s poorest children with mental health issues, a local advocacy group is publishing a report that shows significantly more children were treated for behavioral problems last year than in 2013.
About 12,550 children had a Medicaid mental health charge last year, representing a 30 percent increase from 2013, when the total was 9,569 children, according to the report being released Tuesday by the Children’s Law Center.
“This is the biggest increase we’ve seen since we’ve been tracking this issue,” said Ketayoun Darvich-Kodjouri, the communications director for the advocacy group, which has compiled three reports on the issue. “This is great news. But now we need to make sure that those 3,000 kids and many more are getting the right care at the right time.”
The rise in the number of poor children receiving services is primarily a result of increased pressure on mental health service providers and additional spending and more oversight of such providers, the report noted.
The city doesn’t identify how much money it spends on children’s mental health in its budget, but in 2013 the Department of Health Care Finance called spending on mental health services “negligible.”
But during 2014, the report said, the money going to children’s mental health increased. For example, Health Care Finance now ensures that pediatricians who give mental health screenings to children are paid for providing the service. Plus, to increase accountability, the department began releasing quarterly reports that track services provided.
Phyllis Jones, a spokeswoman for the Department of Behavioral Health, said the report showed what her department already knew: more children are getting help.
“This report confirms the government is reaching more children with the mental health treatment they need at an early age when it can make a lifetime difference,” she said.
But it’s not all good news.
“We’re delighted that more kids are getting treatment, but we’re very worried about the quality of that treatment,” said Judith Sandalow, the law center’s executive director. “It’s too fragmented to be fully effective; we know that more kids are getting some services, but we also know that kids are waiting too long to get the services, and the quality is uneven at best.”
The report said that it’s difficult to determine the quality of the children’s mental health treatment, calling it “troubling news” that the only available information involves “limited evaluations and anecdotal evidence.”
Some of that anecdotal evidence, Sandalow said, hasn’t been great. One doctor prescribed to a child a medication that no longer exists. Other children, she said, have waited as long as five months to be treated for mental illness.
One girl, the organization said, went through a barrage of therapists over a short amount of time. “She ended up with at least seven therapists over the past two years — which meant that she could never make any real progress,” Darvich-Kodjouri wrote in an e-mail. “At the end of the day, this meant that even with medication her condition worsened and she couldn’t function in the community or at school, and she became homebound.”
What’s more, Sandalow said, thousands of additional District children probably still need help but aren’t getting it. The Department of Behavioral Health says 13 percent to 20 percent of all children experience a mental health disorder during the year. Right now, the report said, only 13 percent of children on DC Medicaid are getting mental health care.
Sandalow says she suspects that as many as 20 percent of children on D.C. Medicaid need mental health care. “Given that we have such a high concentration of poverty and so much trauma, we think we’re being reasonable when we say that the [rate of mental disorders among poor children] is at the high end.”
There’s general consensus among psychologists that the earlier a mental health expert can pinpoint an issue in a child, the better. Studies show that children who don’t receive treatment for mental health issues are significantly more likely to break the law, commit suicide or drop out of school. About half of the students with mental health issues who are older than 14 drop out of high school, according to the National Alliance on Mental Illness.