Let me say right up front that this is a letter of thanks. Something remarkable is going on in children’s mental health here in Massachusetts. We’ve been pretty quiet about it and I’m not sure why. I think we should be shouting it from the rooftops every chance we get, don’t you?
As you know, a girl named Rosie D and her family got together with others like them and sued the Commonwealth of Massachusetts a few years ago. Her family believed that children should receive mental health treatment in their communities whenever possible instead of going to residential programs or hospitals. The state had a few small programs to fit the bill, but not enough to even start to go around.
The federal judge wrote in his decision that Massachusetts needed to change how it delivered mental health services to children and youth receiving Masshealth a year before you became governor. But when those families went to court, they wanted a remedy, not money or damages. What landed in your lap was the task of creating that remedy and having it meet the needs of all those children, youth and families that were counting on it.
There are lots of children and youth here that need these services in order to have the kind of life their parents want for them and that they deserve. Epidemiologists tell us that 1 in 5 children experiences a mental health disorder during the course of a year. That comes out to 286,600 children in the Commonwealth. For most of them, there is a delay before they receive treatment, often a delay of years.
Since that judge issued his order, the people on your staff have created something amazing and unprecedented. They designed the Children’s Behavioral Health Initiative and they said they were going to change how things work for children and teens like Rosie D. They made sure the services were in the community. They created a model where families were part of the team figuring out what care was needed. They designed a new way to respond to mental health crises (and we all know that children have their crises at inconvenient times) so that the team came to the family instead of the parent and child trekking to the emergency room. And it’s up and running all across the state.
As with all new initiatives with this kind of scope, there are still things to work out. Sometimes the services don’t work the way they should. Sometimes children don’t get what they need right away. Sometimes we just need to tweak things and sometimes significant advocacy is called for.
My father, a New Englander to the core, used to say that you can’t learn to ice skate without falling down. While no one wants to see mistakes, we can learn from them. Parents want their experiences, good or bad, to make it better for the next family behind them. Parents want to and will be the Amazon.com reviewers and consumer reporters of the services that their children receive. I wish there were a way to make sure their experiences were collected and used to improve the design, the practice and the kinds of outcomes we focus on. Their input is incredibly valuable. Can we think about that?
You probably know all this, but what you don’t know is how the rest of the country — or at least those who pay attention to the children’s mental health world — finds this both jaw dropping and exciting. It’s not just what’s been done here, its the scope of it. When I go to an event with people from other states, they come over and want to hear the details. They want to know how families see things, how this new initiative has changed our system of care for children in Massachusetts and they are hungry for both data and advice.
People in other state governments want to hear about our successes, our roadblocks and how we continue to improve things. Researchers want to hear about our data and outcomes. Policy makers are interested in how this has impacted other children’s services, funded both by the state and by private insurers. Families want to know how they can help build something similar in their own states.
We all need good news in these tough economic times. You’ve done something remarkable here despite those tough times. Let’s get the word out. In the meantime, thumbs up.