A pediatrician reflects on the mental health of children and the systems that are trying to help them.
Thursday, May 28, 2009
Notes from the Hearing on H.3586
I am blogging live from the hearing room, although I am unable to post in realtime, so this will appear later. There will be abreak in my notes when I go up to testify.The Committee meeting was attended by about half the Committtee as best I can tell.We led off with the stars: David DMaso from Children’s Hospital Lisa Scannell from MSPCC and Lisa Lambert fromthe Parent Advocacy League. Before our bill came up, Representative Provo spoke of the need to empower Social Workers to be able to make decisions on the children in crisis;licensed social workers on the front line not only make the initial assessment, but need to figure out who can provide the more definitive therapy and should be empowered to deal with it.Then our panel spoke about our bill.Ms. Scannell spoke about the details; the service is clearly defined, the costs are small and the benefits are high.In my view, this is one on the limitations of the bill;there is indeed more to care coordination than collateral contacts, but collateral contacts are part of the business.It is, however, a step in the right right direction.Lisa Lambert spoke ofthe needs of the families with children with mental illness in the Commonwealth.She spoke of how complicated the system is; how parents have to learn the alphabet soup of agencies and plans and how the service structure is not set up to facilitate communication between providers.Dr. DiMaso spoke of the support of Children’ Hospital for this bill;he spoke of an 8 year old boy in a classroom whose teacher doesn’t know what to do;the psychiatrist is treating the child, but the teacher doesn’t know what the psychiatrist is doing.Shouldn’t the mental health provider talk with the other significant providers in the children’s life?He pointed out the MCPAP program is a collaborative care program that has already started to change the culture in Massachusetts, and that, given the prevalence of the illness, we should really be doing this in cases of mental health care.We need to create capacity for systems to be able to handle the program.He also put in a plug for linguistically appropriate care.
Senator Tolman also stopped in to support the bill;he also found the cost to be very reasonable and he thought that this would support the needs of children.Then is was:
Matt Noyes videotaped our testimony and posted it on YouTube:
Our testimony went well-Catherine Apostoleris of Winchendon spoke of the need for collateral contacts to coordinate care in the context of her school based services, and Toni Poti of the Webster Boys and Girls Club spoke of the need for need to integrate services in the community and how collateral contacts were the first step in that direction.The opposition didn’t speak and the chairs asked remarkably gracious questions.Overall, our bill was well supported by all of this testimony. There may have been more but I stepped out of the room, because I ran into an old college classmate who I haven’t seen in 30 yrs, who is also working in the area of mental health advocacy. Small world. When I stepped back inside, I discovered that someone had taken my umbrella while. Is the moral of the story that you should watch your things while testifying? Still, that is a small price to pay when you are trying to get the system to better reflect the reality of treatment in the children's mental health world.
Matt Noyes wrote a nice summary here; he has pictures.