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Child Watch® Column: "Mental Health Support Makes a More Normal Life for Teens Possible"

Release Date: July 25, 2008

Marian Wright Edelman

To a stranger, Samantha Brown, 18, would look like any other teenager. The petite student is dressed in the latest gear, face covered in glitter makeup. Her friendly eyes dance behind oversized glasses while two pink barrettes keep her hair off her face. She's extremely bright and does well in school—she has the highest grade point average in her class. And like most girls her age, she thinks about going to the mall and meeting boys. But Samantha's warm smile and cheerful demeanor belie the emotional fragility and torment that lie inside. Samantha (not her real name) suffers from schizophrenia and has had bouts with bulimia. She writes suicide notes and cuts herself, something she says the "voices" tell her to do. She has an unhealthy infatuation with rapper, "Eminem," Marshall Mathers, which is one of the voices in her head.

Samantha is currently enrolled as a senior in a school for teens with special needs. She has been hospitalized several times for her disorders and has a family history of mental illness. In addition to her mother's post-traumatic stress disorder, her mother's mother, Samantha's grandmother, has been diagnosed with schizophrenia and depression. Her mother lost custody of Samantha after not seeing her for two years. Her family's instability hasn't helped Samantha. By the time she was eight years old, she had lived in three different states. When Samantha met her father for the first time, he was in court giving up his paternal rights to her. She was 12 years old at the time.

Sadly, Samantha's story is only one of millions of children who suffer from a variety of emotional, behavioral and mental disorders. As many as one in five children in the United States has a mental health disorder, and as many as one in ten has a disorder serious enough to impair their day-to-day functioning. Only 20 percent of children and adolescents with mental disorders are identified and receive mental health services in any given year. Abuse and neglect can take a significant toll on children's emotional health, and when they are separated from all that is familiar and are moved from school to school and community to community, those problems only grow worse.

Fortunately for Samantha, she receives appropriate quality care and support at her school from a team of school psychologists and social workers who provide psychological counseling. Medication management also is available to her. She receives occupational therapy to improve her fine motor skills, handwriting and keyboard use, as well as speech and language therapy. Each time she has a dangerous psychological or emotional episode, doctors are available to ensure she gets the treatment she needs.

Samantha has lived with her 78-year-old great-grandmother since she was 10 because of her parents' inability and refusal to care for her. Her great-grandmother works to ensure her safety, but limits her freedom and forbids dating. The two of them subsist on Social Security payments. They also receive some help from others. At times relatives pitch in and help buy food and Samantha's clothes and shoes. But Samantha and her great-grandmother barely get by. Unfortunately, they aren't connected to the financial help available for some of the children being raised by grandparents and other relatives.

Samantha wants to go to college someday but there are big questions as to what will happen to her when her great-grandmother can no longer take care of her. What resources will be available to her when she no longer has the school-based support team of social workers and health professionals upon which she relies? Will she be able to live independently? And who will make sure she eats regularly and stays on her medication schedule?

The challenges of securing continuity of care and appropriate services for youths and young adults, especially those with serious emotional or mental disorders, who are transitioning to adulthood are enormous. A June 2008 General Accountability Report, Young Adults with Serious Mental Illness(GAO-08-678), documents these challenges but also highlights positive efforts underway to address them in selected states and at the federal level. To ensure these youths and young adults receive appropriate support, U.S. Senators Gordon Smith (R-Ore.) and Christopher Dodd (D-Conn.) and Reps. Pete Stark (D-Calif.) and George Miller (D-Calif.) recently introduced the Healthy Transition Act (S. 3195/H.R. 6375).

This measure would provide states planning grants to identify these youths in their states, ascertain the help they are currently receiving, determine what more they need and discover the barriers to getting care for them. The bill would also develop a system for coordinated service delivery and support a quality workforce that understands the mental heath problems of these young adults and can respond to their needs. States also could receive implementation grants to establish youth ombudsman programs; peer support networks, independent living and life skills programs tailored to these youths; systems for improved access to services; and specialized workforce training.

Reforms like these will help to level the playing field for millions of young Americans who deserve immediate attention. Ask your Members of Congress to help ensure that the Healthy Transition Act moves forward this year.


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