Establishes the child psychiatry access project within the office of mental health; establishes a gift for such purpose on personal income tax forms

Summary of specific provisions

Sections one of the bill creates a new section 7.42 of the mental hygiene law directing the office of mental health, within amounts appropriated therefore, to establish regional child psychiatry access projects across the state designed to provide primary care providers with timely access to child psychiatry consulta- tions regarding the children and adolescents they treat. The teams would consist of a child psychiatrist and appropriate support staff who would support primary health care providers in their region regardless of the patient's insurance status. The teams would answer questions, provide consultations, make referrals and in some cases provide transitional support to the child and family until the family can access local behav- ioral health services. They may also provide educational and advocacy services to providers and the mental health community. Section two provides for an effective date on the 90th day after it shall have become law.

Justification

According to a 1999 report of the Surgeon General "About 20% of children are estimated to have mental disorders with at least mild functional impairment." The number of children reported to have "serious emotional disturbance" are reportedly 59% of children ages 9 to 17. Indications are that these numbers have not changed much over the last decade and, unfortunately, the vast majority of these children receive little or no treatment.

A recent report to the Senate Mental Health and Developmental Disabili- ties Committee from the NYS Department of Health and Office of Mental Health on psychiatric drugs for Medicaid beneficiaries age eighteen and under concluded that "the greatest problem in children's mental health is that most children needing help get too little, too late." At the same time as children are suffering untreated, many are also being treated with medications some of which have not been approved by the FDA for use in children and adolescents. While these medications may provide great benefit there is the potential for serious adverse side effects. There is growing concern about appropriate and safe prescribing of medi- cation to children and adolescents with a mental illness. Part of the reason that children are not getting the mental health help they need is that there are significant barriers to referral to behavioral health providers. The President's New Freedom Commission on Mental Health

reported in 2003 that these barriers included "lack of available specialists, insurance restrictions, appointment delays and stigma." The lack of child psychiatrists is a well documented national problem. In New York State there are many counties without a single child psychia- trist. Efforts have been made to pilot telepsychiatry as a way to provide at least some access to rural areas of the state for consulta- tions and assessments by child psychiatrists. However, more needs to be done.

Because of the inadequate numbers of child psychiatrists, primary care practitioners for children and adolescents are often the ones who care for young people with behavioral and emotional problems. Providing primary care providers and families with timely access to expert guid- ance is essential in helping to make informed decisions about psycho- pharmacology and other treatments. This bill aims to provide that resource through regional child psychiatry access teams.

The bill will address the problems of access, inappropriate medication, and insurance barriers by establishing regional teams specialized in child and adolescent behavioral health who will be available to primary care practitioners to consult, answer questions and provide support and referrals for their patients. It is a model that began in Massachusetts in 2004-05 and has proven very successful. In Massachusetts there are six regional teams covering the entire state who are able to respond to the primary care providers in their region, at no cost to the provider or patient, within about 30 minutes of a call. The program is not meant to replace emergency services or on going behavioral health care. This bill will provide support and information to primary care providers and timely access to mental health services for children and adolescents.

With such legislation, "too little, too late," could become a description of the past for the children of New York State.

Prior legislative history

Same as S.7033A of 2007 Veto # 122

Fiscal implications

To be determined.

Effective date

90 days after enactment.