Advocating for A Better Children's Mental Health Plan in Massachusetts

"Children can’t vote, so they are often overlooked in the legislative process. We as pediatricians must speak for them," said MassGeneral Hospital for Children resident Anna Rosenquist, who helped organize yesterday's Residents and Fellows Day at the Massachusetts Statehouse.
At this annual event, she was joined by more than 50 residents and other physicians from Baystate Medical Center, Children's Hospital Boston, MassGeneral Hospital for Children, Tufts Medical Center, and UMass Memorial Children's Medical Center. The event familarized these child health experts with the legislative process and connect them with their legislators during afternoon meetings.

Below is the reason why one resident is an advocate for better services for children:

By Catherine Aftandilian
A MassGeneral Hospital for Children Resident

"It was a Friday night, and I was partway through my shift on the inpatient pediatric unit at the MassGeneral Hospital for Children when I got the call: “We have a 15-year-old female we’re admitting to you after a suicide attempt. She’s medically stable, but we can’t find a psychiatric bed for her.”
Mary, as I’ll call her, had spent the past four days in the emergency room while numerous psychiatrists and case managers scrambled to get her admitted to a psychiatric facility that would be covered by her insurance. By Friday evening, the emergency room staff decided that they were unlikely to find a bed over the weekend, so Mary was admitted to the pediatric floor for monitoring and observation while the hunt for psychiatric placement continued.
When I finally met her late that Friday night, it had been more than 4 days since her suicide attempt, and she and her family looked exhausted. As I interviewed them, I learned that Mary had been feeling depressed for over a year. Her family had been aware that Mary seemed down, but did not understand the extent of her depression. She had not received any outpatient treatment because it was not covered by her insurance. It was frustrating and sad to watch the story unfold and realize that this could have been caught much earlier. It was even more frustrating to not be able to get Mary the treatment she needed in a timely fashion.
It is because of my experience with patients like Mary that I have become involved in pediatric advocacy.
As a new pediatrician, much of my time is spent learning the intricacies of the body, and I am only now realizing that I must begin to understand the intricacies of politics as well. Children cannot speak for themselves and so pediatricians must speak for them.
Through the MassGeneral Hospital for Children Advocacy Group, I have recently become aware of a bill currently under consideration: “An Act Relative to Children’s Mental Health, S.2518.”
This bill dates back to a 2002 class action lawsuit, Rosie D vs. Romney, which was filed on behalf of eight children with serious psychiatric problems who were unable to obtain services at home. The lawsuit claimed that the Commonwealth violated the Early Periodic Screening, Diagnosis and Treatment (EPSDT) program of the Medicaid Act which is designed to assure availability and accessibility of health care resources for low-income children. The trial began in 2005 and involved more than 30 witnesses over 6 weeks testifying about the need for home-based services and the harm that occurs when these services are not available.
In early 2006, Judge Michael Ponsor ruled in favor of the plaintiffs and went on to say that Massachusetts did not provide adequate screening, in-home behavioral and crisis services, case management and care coordination for an estimated 15,000 children with serious emotional disturbances.
This landmark decision resulted in a flurry of activity to remedy the situation.
After 2 years of work and numerous revisions, “An Act Relative to Children’s Mental Health” is currently under review. This bill would improve and expand mental health services for children in Massachusetts by mandating early screening for behavioral health problems, ensuring children are treated in the most appropriate setting, improving insurance coverage and broadening delivery of state services.

Yesterday on Tuesday, April 8, I and other pediatricians from across Massachusetts gathered at the Statehouse to advocate for this bill and others like it. April 8th was Residents and Fellows Day at the State House. It is organized by the residents at MassGeneral Hospital for Children and sponsored by the Massachusetts Chapter of the American Academy of Pediatrics. This event is an opportunity for new pediatricians to gather at the State House for lobbying workshops from leaders in the field, learn about pediatric-relevant bills currently undergoing review, and meet with their own legislators.

Politicians need to hear from parents and other pediatricians about the importance of bill S.2518.
As a parent, if you are interested in supporting this bill, please find your elected officials at http://www.wheredoivotema.com/bal/myelectioninfo.php.
To contact them, please visit http://www.mass.gov/legis/memmenu.htm.

Hopefully through our joint efforts, other families will not have to experience a suicide attempt, 4 days in the emergency room and 2 days admitted to the hospital in order to get their daughter the help that she needs.
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