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Testimony: Department of Mental Health Performance Oversight Hearing (FY11)

Children’s Law Center Executive Director

Judith Sandalow testified before the DC Council Committee on Health on March 3, 2011 regarding the performance of the Department of Mental Health (DMH). 

Sandalow applauded DMH for the steps that they have taken this year to improve the children’s mental health system, crediting Ms. Marie Morilus-Black, Director of Child and Youth Services, with several of the positive changes, but spoke at length about improvements that need to be made to help a system that is in crisis.  She encouraged that city and government officials make improving the District’s mental health system a priority and that all parties work together to address the underlying systemic barriers that impede long term solutions.

For years, a major gap in the array of services available to children in the District has been specialty mental health services.  It’s estimated that between 14-20% of children in the District have an emotional or behavioral disorder, yet DMH serves just slightly over 5% through its two largest programs.  Our lawyers routinely cite this lack of appropriate mental health services as the greatest barrier to success that our clients face.

Sandalow spoke about the need for significant improvements to the quality and array of services that DMH offers. She noted that DC is still lacking many important mental health services for children, such as:

  • treatment foster care
  • intensive day treatment program
  • therapeutic after-school program
  • therapeutic summer programs
  • integrated mental health adn substance abuse services for youth with co-occuring disorders

She also

cited dismal statistics on current service such as the fact that only 50% of children discharged from an inpatient hospital had an outpatient appointment within a week.   Or that less than half of the cases reviewed for quality assurance had findings that the system performed “in the acceptable range.” These unsurprising results are supported by years of anecdotal evidence that demonstrate continued poor performance and point to the fact that this remains a serious issue.

Also serious are the repercussions of failing to improve the array and quality of community-based mental health services.  Without appropriate services, the District is forced to bear the significant financial burden of paying for children to go to residential treatment centers which deliver varied results. Treating children in their community is not only much cheaper, but also less taxing on the child who has already suffered some trauma.  Sandalow commended DMH for its pilot WrapAround program that aims to keep DC’s children out of residential placements, but she reminded the Committee that it and other pilots cannot succeed until the system itself improves.

Sandalow cautioned strongly that unless the District addresses the underlying structural problems that make it an untenable environment for high quality service providers, all of DMH’s efforts at new services and pilot programs will be short-term solutions that offer little hope for a failing system.  Part of the problem, Sandalow acknowledged, is that improving the fragmented and complex structure of the District’s Medicaid-funded mental health system requires a coordinated effort of various agencies.  All parties have conceded that the system is ineffective, yet the search for solutions has been lengthy and with no results. Studies recommend meetings between agencies to commission more studies, while the District’s children wait for help.  Sandalow reminded the Committee that the children of DC cannot wait years for a solution to this immediate problem and urged that the Mayor and the new Deputy Mayor for Human Support Services make mental health services a priority.

Read her full comments here.