Family’s Quest to Help Son, HMO mental-care limits are at issue.
By Jamie Talan
In September, a 12-year-old Plainview boy was busy playing football and making straight A's. But his life would change dramatically in November when he began hearing voices telling him to hurt people he loved - and even himself.
Today ends his third hospital stay since then - an end dictated by the family's health care plan limit of only 30 days a year for inpatient mental health treatment. So he is due to be discharged from Schneider Children's Hospital in New Hyde Park, part of Long Island Jewish Medical Center.
Doctors still can't say what's wrong with the boy, according to his mother.
"I just can't believe this," said Cheryl Russell, who says that her son had written a suicide note, called a friend to say goodbye and tried to open the car door en route to the hospital.
Doctors and social workers agree that her son needs outpatient psychiatric treatment, Russell said, but there aren't enough programs to meet the demand.
"I want my kid back. I need help to get him back," she said, "not a waiting list."
Each year, mental health experts estimate, thousands of children are hospitalized for mental health problems. "There is a public health crisis in the United States today," said Dr. Harold Koplewicz, a leading figure in child and adolescent psychiatry who was director of the Schneider program before going to New York University to create the Child Study Center. "Unfortunately, we don't have quick treatments for serious psychiatric disorders."
He said that 12 percent of children and teenagers - 10 million people - have a diagnosable mental health problem, yet only one in five receives effective treatment.
"The managed care programs are not managing care - they are managing costs," Koplewicz said in an interview. "When a parent places a child in the hospital, it's because his behavior is really out of control. To force a child out of the hospital without any aftercare plan is a time bomb."
Calls placed yesterday to Russell's doctors and to his health maintenance organization, HIP, were not returned. But Terry Lynam, a spokesman for Schneider Children's Hospital, said that "even if a patient's benefits are running out, the patient would not be asked to leave if in the doctor's opinion he or she is still in need of acute care."
Joseph Glazer, president and chief executive of the Mental Health Association in New York State, is lobbying on behalf of a bill called Timothy's Law, inspired after the death of an upstate 12-year-old who hanged himself. After a few years of care, the boy's family could no longer keep up with the costs.
The measure seeks managed care coverage for psychiatric problems in line with benefits for physical health problems. Though passed by the Assembly, it hasn't been scheduled for a vote in the Senate.