Latino Children Play Swing (Photo credit: epSos.de)If you have been reading any of my posts, you know I talk alot about kids with mental health issues and the struggles they face in school and in their families. But what about the kids who may have other issues to deal with? How about a deaf child that also has mental health needs? Where do they go? Yes, due to the ADA law, hospitals and treatment facilities must be able to provide the appropriate accomodations for any client that has a disability like bilndness, hearing loss, etc. And they do a pretty good job of providing these services at their own cost. In the case of mental health treatment either in an office or a facility, the ability of the interpreter to not only translate the spoken word but the inferences and nuances of the conversation are critical. It is unadvisable to use family members as interpreters as there may be family dynamics that add to the issues presented. But some therapists do this becuase the cost of a qualified ASL interpreter can be anyhwre from $50 to $80/hour depending upon the exact needs of the session. Scheduling becomes as issue. What if there is a no show and no call on the part of the interpreter? How about if the patient doesn't show? The entire burden of the costs currently rest with the therapist or healthcare provider. Most of these kids will likelyy have Medicaid or CHIP with some having private insurance, which also increases the possibility there will not be enough appropriately trained providers to serve this population. Doctors arde already limiting the number of Medicaid cases they can take due to the low reimsursement and slow pay rates. Schools deal with this as well. But lets look at a particularly difficult gap to explain or ignore. What if a child has mental health issues that can be stabilized, but due to his history there are massive behavioral needs for this child? Is there a place within the state that can treat a deaf child in a behavior modifictaion setting for a long term period for the rates offered by Texas Medicaid, either traditional or managed? The answer is no. The State School for the Deaf can handle the eductional part, but when the behaviors get too intense they cannot keep the child. We are talking about depressed kids, not homicidal or violent ones, just severly depressed , possibly suicidal kids. What about other places? There are a couple of other possibilities. Austin State Hospital
, one of the few State hospitals that accepts kids, has a program for hearing impaired patients. But because of the way the state funds are divied up between the Mental health authorities, a kid from Austin County may not be able to get that specialty bed in Travis County. So back to square one. We have a kid in a mental health hospital that is as stable as she can be there, but is not well enough to go home safely due to some aggressive outbursts which places the rest of the family and the child in threat. Outpatient is not the best possible option due to the behavioral aspects, and most behavioral interventionists will not work with a child while they are still in an acute hospital that is not set up for that type of treatment. What are we to do with these children? Where do they turn for the same level of medical care we all can access without too much trouble. What if there were no options foryou? Would you feel like a valued part of society?