Kids need facilities that will treat them close to home

Back in my misspent youth, I studied nursing in New York City.  Part of the curriculum involved going out to an adult mental institution called Manhattan State on an island in New York harbor.

There were three tall buildings on the island. The higher the level, the more extreme the affliction. Student nurses rarely, if ever, got about the third floor. About that same time, a young reporter named Geraldo Rivera did some investigative journalism that led to the exposure of an institution for kids called on Long Island.  The place was a horror house of kids with mental illnesses and low mental functions thrown together and left in their own excrement, often without even clothes.

Not long after that, mental institutions were emptied out across the country with the promise that community mental health centers would replace them and help the mentally ill or challenged to live more normal lives, integrated in society but supported by specialists within easy reach in each neighborhood.

That promise has yet to be fulfilled.

I can’t imagine us going back to a time when we shut the mentally ill up in tall buildings with big locks and let them waste away. I hope that places like that will forever remain in the past.  But there are times when institutionalization is the only answer, at least temporarily, for some people, including some kids on my caseload.

There are no long term locked treatment facilities in this state for our most damaged children. The only locked facilities for children in Alaska are places like the McLaughlin and Fairbanks Youth Facilities. There is no way to spin those facilities into something other than what they are – kiddy jails.  They are for children who have committed a crime, not for children who have a mental illness and need the security of a locked program to protect them from their own unsafe behaviors.

Locked treatment facilities available to Alaska’s children, as noted in an article in the Daily News not too long ago, are in the lower ‘48. Sending a child that far from home and family creates its own set of problems over and above the initial problem with which the child is dealing.

When children are in treatment far from family, it makes it difficult for family to participate in counseling – an often critical part of successful recovery. And if a child does make progress and starts to open up, that invariably leads to a review of the child’s status. If that review shows enough progress, then the kid no longer qualifies for that level of care.

What this means is that at a time when a kid is finally willing to trust a counselor enough to open up, the child is packed up and sent back to Alaska where they have to start from scratch in building a new relationship with a new counselor.

It means that the children who most need stability, who need the most time possible to learn to trust enough to disclose their issues, go through a major upheaval just as they are reaching that point.

When state health officials blithely talk about building these facilities in state so our kids aren’t sent away, I want to ask where they are going to get the money. And it’s not just construction money. Where will the annual operating budget come from? State health officials talk about building new facilities while they cut funds from programs already critical to children like foster care payments.

Words are cheap.  Facilities that can serve our most needy children are expensive. Robbing Peter to pay Paul is both voodoo economics and voodoo health care. And sound bites with no substance behind them are just voodoo public relations.

(Ok, yes, it was THAT Geraldo Riviera.)