The Free Press, Mankato, MN

February 13, 2013

Children's mental health boosted by Sheran bills

By Dan Linehan
The Free Press

MANKATO — Sen. Kathy Sheran introduced a pair of bills Wednesday that she believes will lead to more early intervention to treat mental illness in children.

"If we intervene early, provide supports for the family and decrease stress and anxiety around the illness, we have better outcomes," the Mankato Democrat said.

The bills call for at least seven changes, mostly expansions to state-funded services.

Perhaps the largest is a $5 million-a-year expansion of a grant program to bring mental health services into schools.

Dr. Mark Sander, a clinical psychologist with Hennepin County, testified at the Senate's Health, Human Services and Housing Committee that problems with child care, transportation and having to leave work are barriers to children getting mental health services.

"If your child needed therapy weekly, it's a lot of time for a student to be away from school," he said.

He said a similar program in Minneapolis, running since 2005, showed a correlation -- he didn't say how strong -- between the program and scores on reading tests.

Gov. Mark Dayton included $7.5 million for the program in his two-year budget, so Sheran's bill would increase that amount by $2.5 million over two years.

It's a program that would have helped Jennifer Thomas, a Maple Grove woman who testified about her family's struggles to treat the mental illness of their 12-year-old son, who is currently hospitalized.

She said her son has "scary, negative thoughts that are hard to understand and hard to get out of his mind."

"He has reported at times he'd rather not live at home because he is afraid he will hurt his siblings if his symptoms get out of control," she said.

It would have helped, Thomas said, to have mental health care in the schools.

She said other problems included long waiting lists, a lack of coordination in the mental health system and a lack of coverage from private insurance causing more out-of-pocket expenses than they can afford.

Young adult support

Another piece of Sheran's legislation would require case management services -- wherein a county employee helps a client coordinate their mental health care -- to be extended to age 26 for children who qualify. As it is, adults have a more difficult time qualifying for the service than children do.

"It's based on their age, not on what's appropriate for the client," Sheran said of the existing rules.

Sue Abderholden, executive director of the National Alliance on Mental Illness in Minnesota, told the committee, "I like to say that 26 is the new 18."

She said she knew counties, which employ case managers, are concerned with this change.

Stacy Hennen, social services director for Grant County, testified that counties agree with many of the services in the bill, but would like the Legislature to consider the cost of this expansion.

The cost of this provision, and others, has not yet been calculated but will soon be.

Insurance change

Among the bills' reforms is a regulatory change for insurance companies.

It would change the so-called "formulary" -- a list of drugs compiled by an insurance company that states what sort of medicine they cover -- in cases where a child was having his or her first or second psychotic episode. As it stands, a formulary may require, for example, that a child take a certain drug for a certain amount of time before trying another (perhaps more expensive) drug.

"We want to relieve the prescriber from having to work within the constraints of the formulary," Sheran told the committee.

She added later: "The best practice would be to do what we can as fast as we can."

Training, more reforms

The bills' other changes include a $45,000 appropriation for training on how to deal with mentally ill children. It would be directed at teachers, social service personnel, law enforcement and others.

It also includes a provision that would offer at-risk families -- in this case defined as families that have been the subject of a child protection investigations where no abuse or neglect has been found -- some services, such as in-home consultation and education.

Sheran said the bills are "not a complete response, resolution or solution" but are worthwhile steps to take.

Big day for Sheran

Though Sheran, the committee chair, helped shepherd two of her own bills through (both passed with bipartisan support), she said her legislation will have some company.

"Be assured you'll be seeing several other people at this table besides me. We're calling this our mental health day," said Sheran, who has an extensive history in the mental health field.

The bills, which have companions in the state House of Representatives, now move to the finance committee.