REFORM PLAN LEAVES CHILDREN AND ADOLESCENTS BEHIND

REFORM PLAN LEAVES CHILDREN AND ADOLESCENTS BEHIND

By Ronda Fein, PhD

First published: Saturday, August 8, 2009, Albany Times Union

In his very articulate July 27 commentary, "It's not reform when it hurts the poor," Andrew Malekoff expresses concern about the state Office of Mental Health and the state Health Department pursuing a "reform" plan that will leave a significant number of children and adolescents without access to mental health care.

The plan will assure continued access to care only to children and families with Medicaid fee-for-service insurance coverage but not to families that have no insurance, or insurance with limited mental health coverage. Families struggling with serious emotional challenges will have trouble finding help if not covered by Medicaid fee-for-service. Clinics and mental health care providers will not be able to continue to accept the low rates offered by Medicaid managed-care carriers and families will not be able to access help.

Anyone who has been through a period of time with a child who is seriously depressed, anxious or behaviorally challenged knows how it affects every facet of one's life.

Our society has moved toward a very misguided view of treatment for mental health issues as being provided in a pill, mainly as a result of pharmaceutical companies' marketing efforts. Medication may be helpful but there is no substitute for the intensive work provided by community clinics, which can target the whole family.

As Mr. Malekoff suggests, the Office of Mental Health must also restore and enhance local assistance funding, which includes a partnership among local and state government, local community and client-consumers for specialty children's outpatient mental health clinics that serve non-Medicaid fee for service clients. Low- and middle-income families deserve access to this care, which is often provided by high quality community-based mental health clinics.

Ronda Fein, Ph.D.

Saratoga Springs
The writer is a licensed clinical psychologist in private practice.