Community Mental Health the Question

Community Mental Health

The question of whether people in my local area have access to community mental health services is a complicated and difficult one to answer, because the answer depends on both who is trying to access mental services and what type of services they are trying to access. The short answer is that there is some type of mental health service available for people in need in my community, and that many of these services are available for free or on a sliding-scale basis for people in lower socio-economic groups. The more complicated answer is that my community does not have adequate mental health services to meet the needs of the community and that there are certain groups who have virtually no access to mental health resources.

Adults in the community can access a wide range of mental health services. There are a number of support groups, many based on 12-step models that offer some type of mental health services for free. These groups include, but are not limited to: Alcoholics Anonymous, Al-Anon, Overeaters Anonymous, Narcotics Anonymous, and a sex-addiction support group that does not have a program name. There are also support groups aimed at helping people with Post-Traumatic Stress Disorder, survivors of sexual assault, and grief support groups. People who need more intensive care or do not respond well in group settings can access free or sliding-scale mental health services through the local MHMR (Mental Health Mental Retardation) offices. Furthermore, adults who are experiencing emotional distress have access to mental health resources through involuntary commitment proceedings, which are quasi-criminal in nature and provide for mental health services funded by the community. In addition to all of these services, adults can access many private-pay therapy and mental health services. The "Texas Department of State Health Services Mental Health and Substance Abuse Division funds providers of mental health and substance abuse services who then assist those in need of such services" (TDSHS, 2010).

However, it appears that juveniles are tremendously underserved in the community. One of the things that I noticed is that juveniles with emotional or mental health problems seem to be diverted from the healthcare system into the juvenile justice system. Rather than treating their problems, the community attempts to punish them for their behaviors, placing them in systems where they rarely have access to the type of treatment that will teach them how to avoid engaging in further antisocial behaviors (Thomas & Penn, 2002). In fact, the overrepresentation of mental illness in the juvenile delinquent population as compared to the normal population suggests that the shifting of ill kids to the criminal justice system is commonplace.

Even more troubling is the idea that juveniles who are not involved in the criminal justice system but who experience significant mental health issues may not have access to mental health care. Out-of-pocket expenses for residential mental health treatment for adolescents are exorbitant, even for parents with health insurance. Copays can literally be thousands of dollars a week. However, parents who cannot afford those costs may find the state unwilling to help them; parents are asked to relinquish parental rights if they want the state to help fund residential treatment interventions for juveniles, a scenario that many parents will severely ill children find untenable.