So children don't suffer

IT COULD be a child stuck in a psychiatric ward because she needs but can't get access to less intensive care. It could be a boy who has been expelled from pre school, or an 11-year-old girl disrupting her classroom.

Their common problem is that they suffer from mental illness and they haven't gotten the right care. It's a national issue. One in 10 children and adolescents suffer from mental illness, according to a 2001 report from the US Surgeon General, but fewer than one in five of these children are treated.

Pending state legislation would help by ushering in an era of reform. Today, lawmakers will hold a hearing on An Act Improving and Expanding Behavioral Health Services for Children in the Commonwealth. As its long name suggests, the bill is a sprawling plan that calls for change in schools, preschool programs, insurance coverage, and in state government.

The goal behind this sweeping approach is to reach children wherever they are and give them uniformly excellent care.

The bill would put the state Department of Mental Health in charge of children's mental health, so responsibility would no longer be scattered across agencies. So whether a child was on welfare, detained by the Department of Youth Services, or in public school, their quality of care would be consistent.

One pillar of the bill is its call for more early intervention, helping families quickly spot and treat a child's mental illness. The bill asks pediatricians to screen for behavioral health problems and would require Medicaid to pay for these screenings. And the new Department of Early Education and Care would have to provide behavioral health consultants for preschools and child-care programs.

The bill would also update the healthcare parity law that the Legislature passed in 2000, by clarifying that all mental health disorders should be covered by insurance. And the bill says private insurers should cover "collateral" services, such as child therapists who also treat parents and work with doctors or teachers. If therapists aren't paid for this work, which creates a healthier environment for children, there's less incentive to do it, says Representative Ruth Balser, a Newton Democrat and sponsor of the bill along with Senator Steven Tolman, a Brighton Democrat.

To help "stuck kids" covered by Medicaid move out of inpatient care, the bill would create a fund to pay for the move, while state agencies figure out which of them should pay.

Marylou Sudders, president of the Massachusetts Society for the Prevention of Cruelty to Children, says that implementing the bill would cost an estimated $10 million a year.

Balser calls the bill a work in progress and says she is eager to gather information from the hearing and use it to strengthen the bill.

It's a process that should occur with all due speed, so that children can get the best care.