What does this indicator measure?
This indicator measures the number of children receiving mental health services through NorthSTAR. (Dallas County Mental Health and Mental Retardation provided services from 1990 to 1999, and NorthSTAR Medicaid Managed Care provided services from 2000 to 2005.) The data was collected in collaboration with
Beyond ABC: Growing Up in Dallas County, 2007, a report issued by
Children’s Medical Center Dallas. The underlying data sources for this indicator are the Dallas County Mental Health and Mental Retardation, 1990-1998 and NorthSTAR Data Book, 2001-2005.
Why is this indicator important?Publicly funded mental health services in the Dallas area operate in a complex environment. The state funds mental health services through multiple programs, including NorthSTAR, the juvenile justice system, traditional Medicaid, CHIP, and Early Childhood Intervention Services. No entity documents the total number of children receiving these publicly funded mental health services.
How are we doing?
Texas ranked 47th in the nation in funding for mental health services in 2003. Less than one third of U.S. children and adolescents with mental disorders receive appropriate treatment, according to the federal Center for Mental Health Services. Young people who are mentally ill or exhibit severe emotional disturbances are at risk of dropping out of school, being unemployed, abusing drugs and alcohol, being arrested and becoming violent or pregnant. In 2005, 45 percent of the young people sent to the Texas Youth Commission had severe emotional disorders.
Children Receiving NorthSTAR (Medicaid) Mental Health Services |
| 1990 | 1994 | 1996 | 1998 | 2000 | 2002 | 2005 |
Dallas County | 1,600 | 2,548 | 4,178 | 5,15 | 6,623 | 6,416 | 8,806 |
Source:
Beyond ABC: Growing Up in Dallas County, 2007, a report issued by
Children’s Medical Center Dallas.
The continuum of care for children with mental health needs in Texas is broken, according to “Children’s Mental Health Services in Texas: A State of the State Report, May 2006” issued by the Children’s Hospital Association of Texas (CHAT). The limited state resources and fragmented funding streams for mental health services result in a focus on crisis treatment, a strained capacity, and insufficient coordination of care among agencies. In addition, the statewide shortage of child psychiatrists and residential care results in lengthy waiting lists. Dallas County also lacks adequate psychiatric emergency room facilities and crisis mental health intervention services for children and youth.
The number of Dallas County children receiving publicly funded mental health services has increased significantly since 1998 through the NorthSTAR pilot program. NorthSTAR integrates behavioral health (mental health and chemical dependency) service delivery systems for children enrolled in Medicaid managed care or who come from low-income families and are uninsured. Despite the substantial increase in access to children’s mental health services, community concerns about the NorthSTAR program include inadequate funding to meet the needs, an inadequate network of providers, and a lack of effective coordination between the health and behavioral-health managed care networks.
Mental health benefits in the Children’s Health Insurance Program (CHIP) are substantial, but CHIP HMOs may limit access to services by approving only a limited number of visits.
CHAT recommendations for action include increasing state funds to support community-based services, requiring mental health benefits be on par with physical health benefits, improving the identification and treatment of mental health issues in preschool-age children, reducing barriers to Medicaid/ CHIP enrollment and continued coverage, and increasing oversight and coordination of children’s mental health services.