Sunday, March 21, 2004

Our responsibility to mentally ill


When it comes to facing up to society's responsibility to children, it is not enough for the state to say money is an obstacle. Yet that is exactly the response being made in Ohio today to the appalling inequities and institutional cruelties of Ohio's mental health treatment system.

The weaknesses of this system are exhaustively detailed in a two-day series, "Troubled Minds, Chaotic Care," by Enquirer reporters Debra Jasper and Spencer Hunt that begins on today's front page. More than 86,000 Ohio children suffer from some form of mental illness, and the families of most of them don't have insurance that begins to cover the full treatment they need.

Gov. Bob Taft acknowledges "the terrible problem," but says the state can't afford to help. "We've been hampered by the lack of resources. It's very frustrating, but it's a reality," he told the reporters. Requiring health insurance companies to provide mental health services at the same level as physical health services would help alleviate some of the problems. But Taft has called for a moratorium on any new insurance mandates, saying such requirements raise rates and place too much of a burden on businesses.

Among the most heartbreaking findings in the series is that during the past three years, as many as 1,800 parents have voluntarily given up custody of their children to the state because that is the only way they can ensure that the government will pay for the treatment their children desperately need. Any government that pushes parents to give up their children to help them is not being budget-conscious. It is being barbaric.

We are talking about children who need full-time, long-term care. By obtaining custody of the children, the state can get federal money to cover treatment costs of up to $1,000 per day. But when the parents give up custody, they also give up any voice in their children's care, or even where in the state the children will be institutionalized.

Two bills are pending in Columbus that would address some of the problems outlined in this series. Both deserve General Assembly action, despite Taft's call for a moratorium.

The first, passed by the House in February, would require insurance companies to offer mental health care at parity with physical care. Rep. Lynn Olman, R-Maumee, the sponsor, notes that the state already offers such coverage to state employees. His proposal, which faces strong opposition in the Senate, would cause premiums to increase only 1 percent. On a $100-per-month premium that would be an increase of $1.

The second bill, by Sen. John Carey, R-Wellston, would require counties to pay for treating uninsured mentally ill children, without forcing parents to relinquish custody. Parents would be required to help pay for their children's care based on a sliding scale. Parents would be included in treatment plans under agreements that would be supervised by the courts. Opponents argue such a system would limit state control over how public money is spent and increase the overall cost of treatment.

Money should not be the overriding factor in these cases. Humane and equitable treatment of children should be the state's primary concern, and it is time for the governor and the legislature to meet that responsibility.

Our responsibility to mentally ill

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