Overview: What’s
currently not working in the parent initiated treatment process?
1) Youth in need (sometimes gravely disabled or likely to do serious harm) are being turned away from in-patient treatment facilities
2) Responsible parents are experiencing loss of authority to initiate treatment for youth
3) Public authorities are reluctant to detain or impose restrictive conditions on youth who are severely emotionally impaired
Symposium: Parent/Caregiver-Initiated
Treatment of Minors
Over 60 people registered and approximately the same
number attended a symposium on the topic held on January 6, 2010. The symposium
was hosted by the Division of Public Behavioral Health and Justice Policy at
the University of Washington’s School of Social Work. Its goals were to:
·
Increase
public awareness of challenges facing families and society from untreated
illness leading to legislation to improve the situation
·
Clarify
the intent of Washington State law
·
Educate
concerning the process in the current law for obtaining in-patient and
out-patient treatment for a youth of age 13 or older
·
Identify
a process for recommending potential improvements to the law to help prevent
through parent-directed care the worsening of mental conditions that endanger
life or cause suffering and pain
Parent advocates Sherry Axson and Cathy Clem introduced the symposium.
Stakeholders who
attended or expressed interest in participating in some way included:
Parents of affected youth across the state
Youth involved in behavioral health systems
University research directors
Psychiatric Doctors in multiple counties
Chemical Dependency treatment providers
Legislators and their representatives from multiple districts
Parent advocates
Civil rights attorneys
Defining the
problem
Dr. Eric Trupin from the Washington State Division of Public Behavioral Health and Justice Policy began by describing the variation in accepted age of consent for medical decision making across the states. His presentation included a summary of what the literature says about cognitive ability versus age.
Ron Jaeger of Washington Dads followed with a presentation of the survey results of opinions on hypothetical cases involving parent/caregiver-initiated treatment for minors.
Parent advocate Ann
Varpness hosted a panel of youth and parents featuring Julia, Elizabeth,
Kristin, Donelyn and Erik to discuss answers to the following questions:
1) Would you share with us your experiences with being
told by someone else that you needed to get inpatient or outpatient treatment?
2) What was it like for you when you entered a
treatment facility for evaluation? (fears, barriers, etc.)
3) Where you connected with any peer support during the
process?
4) Please share with us your challenges with attempting to
get help when you suspected that intensive treatment might be necessary for a
son or daughter.
David Lord of Disability Rights Washington spoke about current children’s mental health reform litigation.
Developing a
process for a potential solution
After lunch, the focus shifted to presentations and discussions related to solutions. Dr. Eric Bruns of the Washington State Evidence Based Practice Institute described effective children’s mental health services and supports in our state. Representative Mary Lou Dickerson delivered an overview of recent legislative successes to improve children’s mental health including the state’s pilot wraparound program and underscored her commitment to continual support as the chair of the Washington State Human Services Committee. Dr. Charley Huffine, the Medical Director for Child and Adolescent Mental Health programs in King County, presented ideas related to managing age of consent laws. Ron Jaeger presented some potential areas for process improvement including references to the Bazelon Center for Mental Health Law’s recommendations for the definition of Medical Necessity and DASA’s Parent Guide for Chemical Dependency Treatment Options for Minors Under Age 18.
Where do we go
from here?
The Symposium wrapped up with Cathy Clem, Sherry Axson, and Ray Pate gathering the suggestions from the audience on next steps to take.
1. Representative Dickerson offered to ask staff to conduct a survey of hospitals to work on a better response to dealing with parent-initiated issues. The objective would be to find out which hospitals are saying “yes” to treatment and why they are saying “yes”.
2. Dr.Trupin as part of the “Models for Change” project concerning mental health alternatives volunteered to help host parent/youth/professional forums to gather information and educate.
3. Other recommendations were made to:
a. Look at definition of Gravely Disabled and discover why hospitals are not accepting.
b. Explore using a WRAP plan for youth.
c. Investigate non-traditional methods for treatment.
d. Provide more treatment options in the range of one month to a year
e. Increase doctor’s accountability for their decisions
f. Develop better transition plans for youth coming back to community from in-patient facilities