Mental illness has been on the minds of many people this week, after the shootings in Tucson, Arizona, on Saturday. A University of Virginia forensic clinical psychologist and professor says in a CNN.com opinion piece this week, “The rampage shooting in Arizona is another anguishing reminder that mental health is the weakest link in our ailing health care system.”
See some examples of what foundations around the country have funded in the area of mental health.
In memory of a victim of the tragedy in Tucson
This first item is not related to mental health care. However, I wanted to report that the family of little Christina Taylor Green, age nine, who died in the shootings on Jan. 8, has created a memorial fund for her at the Community Foundation for Southern Arizona, in Tucson. According to news reports, Christina had just been elected to the student council of her school and was interested in politics. A foundation spokesperson told me earlier this week that the family had not yet decided what the proceeds of the fund will be used for.
Mental Health Care
“The New Orleans Metropolitan Area Family Resiliency Project Helps with Mental Health Problems after Katrina,” Robert Wood Johnson Foundation (RWJF) Grant Results summary, September 16, 2010. The foundation awarded a two-year grant, ending in 2009, to Louisiana State University Health Sciences Center (LSUHSC). The grantee provided training about handling trauma and mental and emotional problems to clinicians, parents, and teachers and also provided behavioral and mental health services to children and first responders and their respective families in three Louisiana parishes “hard hit by Hurricane Katrina.” Among the results of this project are that it developed evidence-based prevention and intervention strategies to prepare for future disasters and inform policy decisions, the foundation said. The project also received funding from the National Child Traumatic Stress Network and the American Red Cross. Read the full report here.
Promising Practices from the Healthy Returns Initiative: Building Connections to Health, Mental Health, and Family Support Services in Juvenile Justice, released May 27, 2010. Published by the California Endowment (TCE). This report contains results of the endowment’s four-year initiative to strengthen the ability of county juvenile justice systems to provide mental health and other services that are needed for youth while they are in custody and in the community, according to a press release. The report looks at strategies used by five California counties, including Los Angeles County. Government agencies, community partners, and private providers collaborated on the initiative. About half the youth detained at the county level in California “have a suspected or diagnosed mental illness,” and three-quarters have a substance abuse disorder, the release states. By putting in place some promising practices, this initiative “accomplished a range of positive outcomes for youth and their families,” TCE maintains. The practices that have been used to identify youth with mental health and other problems and make sure they “receive appropriate services” are actually “simple” and “commonsense,” Barbara Raymond of TCE notes in the release.
Ready for Life and Learning: Healthy Social and Emotional Development in Early Childhood is a new 2010–2012 strategic focus area for the United Methodist Health Ministry Fund, located in Hutchinson, Kansas. The fund explains, “Early toxic stress—such as that caused by stressed families, violence, or the loss of a parent—may short-circuit the development of important skills and abilities for relating positively to others and dealing with adversity.” Too often, the result is behavioral problems in childcare and preschool. The objectives of the fund’s new focus area include screenings for mothers and young children; improving access to early interventions; enhancing health and child services professionals’ readiness for working with young kids; and increasing everyone’s awareness of early prevention and intervention that can head off problems.
The fund has authorized $600,000 for the new initiative. Fund staff are reviewing submissions in response to a request for proposals. (The deadline was Jan. 10.) The grantmaker expects to award funding to two or three programs serving Kansans; the grantees selected will be announced by Mar. 11.
Addressing the Mental Health Needs of Young Children in the Child Welfare System: What Every Policymaker Should Know, Janice L. Cooper and colleagues of the National Center for Children in Poverty (NCCP) at Columbia University’s Mailman School of Public Health, September 2010. Funded by the Annie E. Casey Foundation, in Baltimore, and the Maternal and Child Health Bureau of the U.S. Health Resources and Services Administration (HRSA). This publication looks over “what we currently know about the prevalence of young children [ages birth to 5] in the child welfare system,” how maltreatment or neglect affects their development, and the services that are currently offered to this population compared with those that are needed, a summary states. The publication is based on a June 2009 NCCP roundtable. Citing others’ research, the authors note that kids younger than age three “are the most likely of all children to be involved with child welfare services.” They say that young children who have been abused are later at risk for developmental delays. They conclude by offering several recommendations for federal and state officials and others.
Maine Children’s Mental Health: 2010, Maine Children’s Alliance, 61 pp., released September 21, 2010. Funded by the Maine Health Access Foundation. In this broad overview of children’s mental health status in the state, the alliance points out the “lack of integrated data to effectively measure and evaluate children’s mental health outcomes across systems of care” (such as departments of education and child welfare) in Maine and looks forward to more integrated data resulting from provisions of a new state law. The report highlights the importance of children being screened for mental and behavioral health problems before they start kindergarten; emotional and behavioral issues are often detected then. The report’s recommendations include having data systems track “toxic stress” (including extreme poverty) in children, “so that a child’s well-being” is more broadly understood. “Intensive interventions” early in life can reverse effects of such stress, and “nurturing, protective relationships and appropriate learning experiences” sooner, rather than later, are less expensive and produce better outcomes than later interventions such as remedial education and clinical treatment, the report says.
“Mobile Mental Health Unit Takes to Road,” Renee Dudley, October 24, 2010, Charleston (South Carolina) Post and Courier. This news article describes the South Carolina Department of Mental Health’s mobile clinic called Highway to Hope, which receives funding from the Duke Endowment. The unit, a specially outfitted recreational vehicle (RV), is operated by the Charleston Dorchester Mental Health Center. It will serve patients in areas of the state’s Low Country region, such as Edisto Island, that have been impacted by budget cuts that caused the state to close some clinics over the past several years. Debbie Blaylock, executive director of the center, notes in the article that the mobile clinic is a “cost saver” because it provides preventive care that could keep patients out of high-cost hospital emergency departments. The clinic, which began rolling in November 2010, expects to eventually link patients, via satellite, to an off-site psychiatrist. As of now, either an advanced practice nurse (APN) or a masters-level mental health clinician will be on board the mobile clinic, Matt Dorman of the center explained to me. Sometimes a psychiatrist is on board.
Read more about this three-year, $635,121 Duke Endowment grant, which helps to fund the mobile clinic and funds extended hours at a weekend psychiatric urgent care clinic in Charleston (which opened in 2009). An article in the endowment’s August 2010 e-newsletter explains that these two enhancements to mental health resources in the Low Country are “designed to divert patients from overcrowded emergency departments and psychiatric inpatient facilities.” Today, Dorman confirmed the estimated cost savings (mentioned in the newsletter) from fewer clients visiting such facilities: $279,000 per year. (That is the figure if all grant goals are met.) The S.C. Department of Mental Health also provides funding for both clinics. Grant details: The Duke Endowment’s grant was actually awarded to Roper St. Francis Foundation, in Charleston. This fund-raising arm of Roper St. Francis Healthcare received the grant as fiscal agent for the Charleston Dorchester Mental Health Center, Anne Weston Sass, grants development officer, explained to me.
“New System of Community Health Clinics in New Orleans called a “Model for the Entire Country,” Oct. 20, 2010, an article on the RWJF’s website. Read about the work of Karen DeSalvo, who was an RWJF Generalist Physician Faculty Scholar from 2002–2007. (The $46.8 million RWJF Generalist Physician Faculty Scholars Program, a national program, ran from 1992 to 2008.) DeSalvo, who is at Tulane University School of Medicine, is among the health leaders who hurried to help set up a new system of clinics in the Crescent City area after Hurricane Katrina. Many clinics include mental health services and specialized care, the article says.
Citing a Columbia University study reported on in the New Orleans Times-Picayune, Kaiser Health News (KHN) reported here (in its Daily Report, August 26, 2010) about continuing mental health needs in New Orleans. KHN is a program of the Henry J. Kaiser Family Foundation,
Related resources and commentary:
“Could the System Have Prevented Rampage?” Dewey Cornell, CNN opinion piece, Jan. 10.
“Law Prompts Some Health Plans to Cut Mental-Health Benefits,” Russell Adams and Avery Johnson, Wall Street Journal online, December 23, 2010. The law mentioned here is the mental health parity legislation enacted in 2008.
“Some Mental Health Lessons from the Tucson Tragedy,” David Shern, Health Affairs blog, Jan. 11
“Violence Is a Public Health, Not a Mental Health, Problem,” Paul Gionfriddo (former president of the Quantum Foundation and a former state legislator and mayor), Our Health Policy Matters blog, Jan. 11.
“What Do We Really Know about Foundations’ Funding of Mental Health?” Ruth Tebbets Brousseau (independent consultant) and Andrew D. Hyman of the RWJF, GrantWatch Essay, Health Affairs, Jul/Aug 2009.