Child deaths in families involved with the state Department of Children and Families are more likely in cases where agency workers have spent less time assessing and interacting with parents, a preliminary review by the agency indicates. In recent legislative testimony, a DCF official said that an ongoing review of 248 cases – half in which a child under the age of 4 had died, and half in which there was no fatality – had turned up a number of “risk factors,” including the young age of parents, addiction and mental health problems, and a lack of “quality” contact with DCF social workers. “We found that, in the comparison or control cases (where no fatalities occurred), we were assessing parents more, we were visiting parents more. The quality of home visits were more of (high) quality than those in which fatalities had occurred,” DCF research supervisor Janet Gonzalez told members of the Committee on Children. That finding “feeds one of our recommendations, in regards to enhancing the assessments that we do of families in the home,” she said.
The state needs to enlist pediatricians in screening children for mental health problems, expand school-based counseling services and create regional “care management entities” to help families access treatment, a draft report by the Department of Children and Families proposes. The DCF plan – ordered by state lawmakers in the wake of the Newtown school shootings – concludes that “too many families with children in need of immediate behavioral health services continue to struggle with a fragmented system that is difficult to understand and navigate and lacking in basic capacity across the continuum of services.”
But it stops short of calling for more inpatient and outpatient treatment options, saying more study is needed to identify gaps in care and to see if existing resources can be redeployed. A key recommendation in the plan is that state agencies “pool” existing resources for children’s mental health – an estimated $300 million to $400 million – and re-direct those dollars in new ways. The report does not include data on the usage of existing mental health services or unmet needs. Instead, it calls for that data to be collected, and for a “high level task force” to be convened to lead a multi-year study and redesign of spending on mental health. The plan, which will be refined in the coming weeks based on public input, is the latest in a series of efforts over the last three decades to fix the state’s disjointed system of mental health care for children.
Just a few years ago, it was rare that children with mental health problems would spend two or more nights in the emergency room at Connecticut Children’s Medical Center. Only 40 children stayed that long in 2010. So far this year, more than 250 children have spent multiple nights in the emergency department (ED) – a number expected to reach 500 by the end of the year. As policy makers work to finalize a statewide children’s behavioral health plan, a report by the hospital, obtained by C-HIT, projects that children with mental health problems will spend a total of 3,085 nights in the ED – more than triple the number in 2010. The average stay is about 15 hours, with some children remaining in the ED for 10 days or more.
Ten-year-old Joey Smith shared a celebratory high-five with Heather Kunkel, a mental health professional who was visiting the boy’s Thomaston home. “Things are great, spectacular even,” he said, as the two chatted at the kitchen table. It’s a dramatic turnaround for Joey who met Kunkel when she was summoned to Thomaston Center School because he had threatened to harm himself. Now Joey, who has autism, is back at school with a modified curriculum to suit his individual needs and his parents have access to an educational advocate and community resources. The Smiths are among the thousands of Connecticut families turning to the Emergency Mobile Psychiatric Services (EMPS) — a crisis intervention program that includes a network of 150 mental health professionals who assist children experiencing a behavioral or mental health crisis at home, school or in the community.