A common room at the Children’s Farm Home is currently being used for storage. The facility does not have enough staff to take on more inpatient residents, leaving a building empty. (Amanda Loman/Oregon Capital Chronicle)
It would seem any child experiencing mental health crisis would receive compassionate care, with understanding for how that child and family is impacted by what they are going through. Yet the act of seeking help can be traumatizing.
Take the experience I recently learned about from a colleague and friend. She described that it took over one year to find a therapist that could work with her child. Yet when her daughter discussed her needs with various therapists, what she got was “I can’t work with you – your situation is too complex.”
It may be hard to believe that these are actual responses. However, this is the message that a lot of youth and families hear – especially as services tighten up due to the current behavioral health workforce crisis.
What children, youth and families really need is compassion and understanding. We need a customer-service based approach to care.
Once “the system” understands what someone needs, then that is what “the system” needs to provide.
In Oregon, parents raising a child experiencing significant mental health challenges are repeatedly asked to explain how their child’s behavior got to the point that it is and expected to share anything that they may have done to cause it. Realistically parents are trying to get help for their child sooner, when the problem is first identified, long before things get worse. Lynne Terry’s four-part series for the Oregon Capital Chronicle does a good job explaining what most parents are up against.
In discussions with families, this is what they tell us they need:
1) Understand what we are going through.
2) Systems and providers blame families and youth when they do not understand how or have the resources to help.
3) When a child or youth and family cannot get help when they need it, things are more likely to get worse.
Our behavioral health system needs to be driven by the needs of the youth and family seeking care, treatment and services – and not by how agencies are paid and what services they may have available. If there were a ‘Yelp’ app for behavioral health services, things might look a little different.
Imagine if you checked that app and were able to see the 10 top-rated children’s mental health providers. If I were a provider in this scenario, I would not want to have a one or two-star rating, and three stars would be questionable. While we don’t have such a system, the point is well taken that the experience families and youth when seeking care is probably one of the highest priorities that could shift the system forward in a very good way.
Fundamentally, to truly help customer experience and access to services, Oregon needs to go beyond its current siloed approach to funding. In a siloed system of care, children and youth may have access some services and supports. However, getting that care to follow our youth throughout time is difficult if not impossible.
Services and supports at every level of the system may not be available for everyone and often cannot be paid for outside of the extreme crisis. This creates problems with behavioral health access at every level.
Oregon’s recent investment in children’s behavioral health is helping; however, the changes related to these investments are very slow to reach families. Oregon needs to take bold action. There are good investments – and families can’t wait another six to 12 months to see the change. They need it now. The whole family is in crisis everywhere we turn.
We believe it is good policy that all children and youth in need of behavioral health services and supports get them when they need them, instead of months and years from now.
Oregon is not the only state that has struggled to address funding challenges. States like Wisconsin, New Jersey, Michigan, Oklahoma and others have taken a different approach and demonstrated that by leveraging multiple funding streams, including the creation of dedicated funding stream from all child-serving systems to support a robust continuum of care.
A SAMHSA Issue brief highlights states and local jurisdictions that have used flexible funding approaches and are seeing increases in the number of available community-based resources that have shown better, more equitable results by offering more culturally matching services. Collaborative and flexible funding allows for increased partnerships with community-based organizations, which is key to building a more robust system of care.
This idea has been discussed in Oregon for a long time. Perhaps those in leadership will make it happen – for the sake of our children and families.
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