Schizophrenia Daily News Blog

Foster Care as a Last Resort to Obtain Psychiatric Treatment for One's Children

Loving parents, desperate to get children the same level of care for severe psychiatric disorders as they could have received for other severe medical illnesses, are often forced to make the ultimate sacrifice - giving the children up to state custody in order to get them the desperately needed care.

In many cases, families who do not qualify for Medicaid, but are covered by a private insurer come to learn that conditions falling into the category of "mental health" are not adequately covered by their insurance, presumably because the cost of such care can be quite high. When unable to afford mental health treatment out-of-pocket, some of these families have taken the desperate measure to relinquish their child to the foster system where they will receive psychiatric care. The practice has become so widespread in Virginia that a 2004 report commissioned by the Virginia General Assembly found that nearly one of every four children in foster care was placed there to seek mental health treatment. In 2001, a survey conducted by the Bazelon Center for Mental Health Law showed the national average of such cases to be in that approximate range, and another report issued by the federal Government Accountability Office in 2001 demonstrated that parents from 19 different states placed a total of 12,700 children into child welfare systems or juvenile justice systems just to get mental-health care.

Chief Judge of the Richmond Juvenile and Domestic Relations Court, Kim O’Donnell says, “The vast majority of the youth in her courtroom are put into foster care because they are abused or neglected. But she’s heard of parents trading custody for care and is troubled by the practice…Parents should lose the ability to make decisions for their kids when they’ve done something wrong.” In this case, we have attentive, caring parents who will lose their ability to make decisions for their children, not because of abuse or neglect of their child, but because they are simply desperate to obtain psychiatric health care for him/her.

What is not perhaps discussed or thought about at the time a family makes the decision to relinquish custody of their child, is that reinstating legal custody is not as simple as a phone call. Parents, who place their children into the foster-care system voluntarily, must go through hoops to reinstate custody. One family (the Mendittos – See "The Last Resort"), who relinquished legal custody of their son Joey to obtain psychiatric care for his neurobehavioral disorder, will have to pass a criminal background check — a requirement that makes sense for abusive family situations, but seems inappropriate in this situation — followed by a court order to return Joey to their family. Other questions that are raised by this practice, is how much say, if any, parents will have in the treatment their child will receive once in the foster care system (e.g., what facility or family will foster their child). And, once in the system, if a decision is made to take him/her out because of a change-of-heart, how long is the process to reinstate parental custody.

In a 9 page advisory opinion, Virginia Attorney General Robert F. McDonnell (R) said that children should have access to services directly through a state program, known as the Comprehensive Services Act, without having to go through the foster care system. McDonnell also said the practice might violate the U.S. Constitution by taking away a parent’s fundamental right to make decisions regarding the care, custody, and control of their children. McDonnel stated,

"It is inconceivable that the best way to provide such services to a child and his family is by an interpretation that tears the family asunder."

The bigger issue at heart is the need for mental health parity. For more information about mental health parity please read: Mental Health Parity: What Can It Accomplish?

Until that mental health parity is achieved, people will seek creative ways to obtain medical treatment for their psychiatrically unwell children. Advocates who work with children are hoping that, although McDonnell's opinion letter does not carry the weight of law, it will help Virginia families who are struggling to get mental health services for their children. Mary Dunne Stewart, policy director for Voices for Virginia's Children, an advocacy group in Richmond expressed that hope by saying,

"This is going to open up treatment opportunities for families who have exhausted all of their options."

Read the Washington Post article: McDonnell Supports Direct Access to Services

The Last Resort: When nothing else works, parents who can’t afford mental-health treatment for their children are doing the unthinkable: giving them away (Style Magazine)

McDonnell Opinion Press Release: Parents Should not Be Forced to Lose Custody of Mentally-Ill Children
Click here to read Virginia Attorney General Robert McDonnell's Advisory Opinion Letter

Further Reading:
Virginia Parents turning to Foster Care for Help
Childhood Schizophrenia and Other Brain Disorders
Insurance coverage for Mentally Ill - Not very expensive