Monday, April 7, 2008

Taking the Long View: What is going on around the country?

My Academy has a couple of interesting things in it websites for those of us embroiled in mental health reform;  please keep in mind that we are actually doing pretty well.  The AAP has given awards to 10 Chapters for their efforts in changing the paradigm for children's mental health care in their states.  Check it out here!  Chapter efforts include building local networks of pediatricians and mental health providers, improving communication and coordination between statewide profession organizations, needs assessments in major urban centers, creating resource directories and promoting  “dialogues in mental health in primary care” meetings between pediatricians, family practitioners, child psychiatrists, and community mental health providers.  As I read through the list, I was impressed by the commitment of pediatricians to address this problem, and how the rest of the country is adopting many of the same techniques that we have used in Massachusetts to get us to the cusp of major system change.  Whenever I get frustrated at the pace of change in Massachusetts, I need to take a look around and realize how long it has take to get us to here.
Second, is a really interesting article from about 4 years ago that looked as mental health service utilization and mental health needs in 13 states from a parental perspective.  They showed that service utilization is not simply predication by need or demographics.  In California, the rich folks get more services than do the poor folks.  In Massachusetts, the opposite is true.  " In Alabama and Mississippi, as well as in the states with the lowest rates of unmet need (Colorado, Massachusetts, and Minnesota), the opposite is true: children from low-income families are much more likely to receive any mental health service than children from high-income families."  Despite Rosie D., Massachusetts frequently does mental health services better than the rest of the country.
Doesn't get us off of the hook.  But somehow, I find it comforting.

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