On July 15 and 17, the Senate Government Affairs Committee held hearings on the issue of parents being forced to relinquish custody of their children in order to obtain mental health care. On July 15, the Committee heard testimony from families and advocates; federal agency representatives then made recommendations to address the problem on July 17.
According to a General Accounting Office (GAO) report of April 2003, over 12,700 children with mental illnesses have been put into child welfare or juvenile justice systems because their parents could not get necessary health treatment. For parents, relinquishing custody is a desperate measure taken only when no other support is available.
Committee Chair Susan Collins (R-ME) said that the GAO report represents “the tip of the iceberg.” She pointed out that “custody relinquishment is merely a symptom of the much larger problem…the lack of available, affordable and appropriate mental health services and support systems for these children and their families.” Sen. Collins characterized public mental health services as “uncoordinated” and “insufficient.” “There is something terribly wrong with the system,” she said.
Rep. Pete Stark (D-CA) pointed to a “lack of adequate mental health coverage” as the cause of “parents being forced to relinquish custody of their children to get them mental health treatment and related services.” He added, “What these children need is quality mental health treatment without being ripped out of the arms of their families.”
Three mothers described their personal experiences of being told to give up a child with mental health problems. Cynthia Yonan of Glendale Heights, Ill. said that she quickly ran out of health insurance benefits when her two young sons were hospitalized for mental health treatment. Her insurance plan, like most, had caps on mental health coverage. Because she could not afford further hospital care, her children left the hospital and came home. Ms. Yonan tried to find the mental health services for the boys, who needed intensive treatment, but nothing was available. She then gave up her job to stay home and supervise the children, who did not return to school. “Despite the loss of my job and income,” she said, “Medicaid was not an option for mental health services because I owned my house and did not qualify under the strict minimum asset requirements.” At this point, the Department of Health and the Department of Child and Family Services told her to relinquish custody of her children in order to obtain mental health services. Ms. Yonan refused. Fortunately, she found a state agency, the Community Residential Services Authority, that guided her to effective residential treatment for her sons.
The panel of advocates included Trina Osher of the Federation of Families for Children’s Mental Health, Dr. Jane Adams of Keys for Networking, and Tammy Seltzer of the Bazelon Center for Mental Health Law. According to Ms. Seltzer, “a lack of access to appropriate and timely mental health services and supports for children…and a lack of oversight for existing programs” are the main causes of forced child relinquishment. Ms. Seltzer argued that it is possible to “remove the barriers” that prevent parents from getting mental health care services for their children. She urged Congress to pass S. 622, the Family Opportunity Act, S. 486, mental health parity legislation, and to approve S. 1248, the Senate version of the Individuals with Disabilities Education Act. Ms. Seltzer also proposed that Congress provide oversight of Medicaid’s “Katie Beckett option,” which affords care to children in their homes rather than in institutions.
The second day of hearings focused on possible solutions. Cornelia Ashby of the General Accounting Office (GAO) suggested increased funding, disseminating information to agencies, effective mental health screening, and training local caseworkers as necessary steps. Charles Curie of the Substance Abuse and Mental Health Services Administration spoke of “the need for prevention and early intervention” and the importance of working with states to promote the “Katie Beckett option.” J. Robert Flores of the Office of Juvenile Justice Delinquency Programs confirmed that parents need to be involved and reminded the Committee that siblings also deserve attention.
Sen. Collins asked the panel to “work together to come up with clear guidance” for states regarding federal funding for a child’s placement in a foster home. State agencies often tell parents that relinquishing custody is required to receive federal funding, but this is not the case. “A lot of elements are out there to help us make a difference,” Sen. Collins said. “There is the Family Opportunity Act, insurance reform, the example of success is some states…We need a seamless approach to mental health services for children.”
