Monday, December 18, 2000
Help for mentally ill teens addressed
By Tim Bonfield
The Cincinnati Enquirer
As Tristate taxpayers continue to pay for out-of-town care for troubled teens, three agencies are taking new steps to reduce Greater Cincinnati's shortage of adolescent substance abuse services.
This month, the Enquirer recounted the frustrations of the Maiorano family of Green Township, which has struggled to find services for one son with mental illness and drug addiction while being overwhelmed with support for another son with cancer.
Much like the shortfall in mental health services reported by the Enquirer, experts agree that families struggle to find care for children with alcohol and drug addictions.
We're looking at points to improve all along the continuum of care, said Jolynn Herwitz, project director for the Butler County Alcohol and Drug Addiction Services Board. We have lots of kids with lots of needs going to lots of places. From the family's point of view, there's no continuity of care.
New programs at the Hamilton County ADAS board, the Butler County ADAS board and Catholic Social Services of Northern Kentucky reflect a gradual rethinking of youth health services that calls for providing more care in more organized ways.
Children with complex problems, such as having mental illness and a drug addiction, need more local treatment options, experts say.
Meanwhile, children with less complicated cases need quicker access to service to prevent their problems from escalating.
Starting in January, Catholic Social Services of Northern Kentucky will sharply expand intervention services provided at high schools.
Unlike prevention classes offered to any student, intervention involves sending high-risk students to meetings with trained substance abuse counselors. Such students would be referred by teachers, coaches and others who see signs of alcohol or drug abuse, said program supervisor John Mallery.
Catholic Social Services had been running similar services for six years at three high schools - Simon Kenton, Scott and Dixie Heights.
A recent grant from the Health Foundation of Greater Cincinnati will allow the program to be offered in 10 more schools Covington Catholic, Bishop Brossart, Boone County, Holmes, Notre Dame, St. Henry, Newport, Holy Cross, Newport Central Catholic and Pendleton County.
We're targeting kids who are already using to help them find ways to make bet ter decisions and get more involved, Mr. Mallery said. Traditionally, these students wind up getting suspended or expelled and reported to the police. We're trying to get to them before it gets to that point.
In the Tristate's most populated county, there are some long-term residential services for teen addicts, but the Hamilton County ADAS board still spends about $300,000 a year to send 15 to 25 teens out-of-county and sometimes out-of-state for intensive residential treatment.
In general, these youths have already gone through years of less intense outpatient treatment and have wound up in county-paid foster care or tangled in juvenile court.
We're sending a lot of kids out-of-county because we don't have the services here, said Sherry Knapp, chief executive of the Hamilton County Alcohol and Drug Addiction Services Board. The (out-of-town) services are good, but the fact that children aren't near their families and support systems is clinically not ideal.
To improve services, the board is working on three projects:
It seeks about $1 million from state and local sources to build a 12-bed residential center for addicted teens. So far, the board has not secured funding.
It plans to launch a youth version of Hamilton County's adult drug court. The adult drug court allows nonviolent drug offenders to get closely monitored treatment instead of a jail sentence. The ADAS board and several other agencies hope a similar program can serve youth with drug problems. Sponsors are waiting for a state office to decide whether to fund the project, Dr. Knapp said.
It also plans to launch a youth version of an adult program called Treatment Alternatives for Safer Communities (TASC). The adult program, started earlier this year, provides case managers who perform drug and alcohol assessments of nonviolent DUI and drug offenders, make referrals for treatment, make sure offenders attend sessions and follow up with drug testing. A launch date has not been set.
The Butler County ADAS board used a $122,000 grant from the Health Foundation to spend a year studying gaps in its treatment services. Unlike Hamilton County, all severely addicted teens must leave Butler County if they need residential care.
Some get care through a contract with Talbert House in Hamilton County. Others go even farther from home, Ms. Herwitz said.
The number of kids going out of town and the amount of money we're spending is increasing every year, she said. So we're looking at changes in how we do business.
The Butler County board used the grant to create a five-year plan. The plan includes more organized monitoring of children with complex problems, more school-based services, and creating a mobile crisis team to respond to family emergencies.
Butler County might build a residential center but not until these other projects are launched, Ms. Herwitz said.
Even as these programs get started, some in Ohio say that this year's tight state budget may force service cuts instead of expansions.
Ohio legislators face a Medicaid shortfall, a court order to balance uneven spending on schools, and a dip in some tax revenues from a slowing economy.
This is not a good time to ask for more money for alcohol and drug addiction services, said Dr. Knapp. There's a lot of fear that we'll have to cut back, even though the problems we're facing continue to get worse.
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