ATLANTA — For months, 11Alive's Investigative team, The Reveal, has been exposing the gaps in Georgia's mental health care system that has caused thousands of children to be surrendered to the state.
The #Keeping series is part of a data fellowship with USC Annenberg Center for Health Journalism. The series shows how the challenges of raising children with severe emotional and developmental disabilities can lead to abandonment.
In the past five years, 1,268 Georgia children were abandoned or surrendered, often due to the child's behavior. More than half of those children were surrendered twice - either abandoned again by their parents, another family member, a foster parent, or an institution that thought it could help.
"That decision, allowing the state to intervene and to take custody of that child just for a healthcare reason, I just can't imagine that difficult moment," said Lt. Governor Geoff Duncan.
11Alive's Rebecca Lindstrom reached out to Georgia lawmakers to ask what role they thought mental health parity and issues surrounding child abandonment should play in the upcoming 2021 legislative session.
Lt. Governor Duncan and Speaker of the House David Ralston said the issues leading parents to make this kind of decision will be examined and that legislation is already being drafted.
"Mental health has kind of gotten left behind and it's important to me that we make Georgia a model for accessibility in mental health services," said Ralston.
Here's what other lawmakers had to say:
Rep. James Beverly – District 143: House Minority Leader
Due to the unfortunate incidents and issues we continue to see with inadequate medical and mental health care, the Georgia House Democratic Caucus will put forth a concerted effort to pass the Mental Health Parity Act, House Bill 49, through our Health, Education, Appropriations, and Civil Liberties (HEAL) agenda during the upcoming session. House Bill 69 would require insurance companies to treat claims concerning mental and substance use disorders in parity with other health insurance claims. We are hopeful this act will address mental health disparities, lessen the drain on state resources and child abandonment issues, and assist families with children who are in dire need of mental and behavioral health care across the state.
Rep. Terry England – District 116: Chairman, House Appropriations Committee
I think you have done an outstanding job with your series in showing and explaining the need out there that parents face dealing with a child with disabilities have. While we have a wide array of services out there for children and adults, as you have seen in your series, it is very difficult to navigate access to them. A lot of that is compounded by the lack of trained professionals that can provide treatment in a safe and effective manner. This is a national issue and not just unique to Georgia as I am sure you have found as well. As we began our work with the House Rural Development Council 5+ years ago, we traveled the state listening to communities and asking what were the challenges they faced. We found that every community we visited brought some type of mental health issue to us – all pretty much boiling back down to the lack of providers or the ability to get providers. While there are many services out there, the waiting lists (as one of your stories mentioned) existed in every place.
We have expanded funding over the last decade pretty dramatically and will continue to going forward, but as I told someone a few days ago, you can only get so much through the funnel. Meaning, until we have more providers able to provide the services, just throwing money at the system does little good for anyone. Trying to push more individuals through a system short of providers does not help the patients either since they are not getting the attention they need to get well or be helped.
Now, I do believe there are ways to coordinate services between agencies much better. The lines of communication between agencies have to be stronger, clearer, more resilient and better able to handle the swings in demand with flexibility. I do know these agencies are working together to make this happen and members of the General Assembly are working with them to address the needs they identify in any way we are able.
I know these and many other behavioral health issues will take up much of our time in the upcoming session as they have taken up much of our time since last session. The why? Because it is the right thing to do in continuing to address them. Our Human Services Appropriations subcommittee with Chairlady Dempsey has been particularly focused on the hoteling issue once we became aware of it late last year.
I know people get upset with the agencies (I would too if I were under the stresses these parents are under) but I do want to say that we have some incredibly dedicated employees that are working daily to help folks.
Sen. Sally Harrell – District 40
Decade after decade, Georgia neglects the needs of families who care for someone living with a major mental and/or physical disability. These Georgia families face impossible emotional and financial challenges, as illustrated so poignantly by 11Alive's #Keeping series. I hope these stories of real children and their heartbroken parents change the hearts of leaders who currently hold the power to unlock the resources these families so desperately need.
This cold-hearted, longstanding neglect by Georgia leaders of the mental health needs of Georgia families must end now. But to do so will require confronting an attitude of dismissiveness that many elected officials hold. Earlier this spring, while speaking to my fellow Senators about the need to help these families instead of passing a tiny tax cut, one of my colleagues described my plea as a "pet project." He said, "It will never be enough... There's always some person suffering somewhere... There's always something that requires me to get up and go to work, so that government can take my money so they can give it to someone else." This is the attitude that we must fight with everything we have to prevent the heartbreak of families so overwhelmed that they have no other choice but to hand their children over to the state.
Rep. Matthew Gambill – District 15
Thank you for highlighting this important topic. Parity is a major issue. In my work as the Co-Chair of the Working Group on Addiction and Recovery, one of our major initiatives we are focusing on for 2022 is parity. Our working group is a part of the large Mental Health Collaborative which is also working on this. As it relates to your feature on Jacob and his parents Chad and Amy Austin (who I happen to know and go to church with), I appreciate the opportunity to learn about their challenges. As the past chair for the Murphy Harpst Children's Home in Cedartown, Georgia, I served on its board for 8 years. This experience helped me to have a front-row seat into many of the challenges we face in caring for some of our most vulnerable youth. I am also involved with Advocates for Bartow’s Children in Cartersville which also has a residential program. Working to increase the reimbursement for our residential treatment facilities is something I have worked on since I started serving in the legislature 2019. [I ] along with Rep. Trey Kelley sent to Governor Kemp in October 2019 requesting additional funds for a provider rate increase. As we head into the 2022 legislative session, I am very optimistic that we will see a significant investment into mental health and substance use issues. All indications from our Governor and Speaker point to their desire to do this as well. I will continue to advocate that an increase for our residential providers be a part of the state’s response.
Rep. Gregg Kennard – District 102
Your reporting on the #Keeping series is important and eye-opening. Powerful stories.
I have some range on mental and behavioral health as I am the director of a homeless transitional program. Homelessness and mental health almost always go hand in hand. That said, there are so many complicated layers to this issue, and you touched on some of these complications that I did not understand fully. So thank you.
As you know, Georgia ranks at the bottom in terms of access to care for Mental and Behavioral health. The quickest, cheapest, most efficient, and comprehensive measure we could take is to expand Medicaid. We would see instant results.
Since that is not likely to happen, we have to find other avenues to apply pressure for additional support.
Here are some silver linings:
- The planets seem to be aligning and the Speaker, the Governor, and Republican leadership have signaled that they want to pass meaningful MH legislation this session. There is an omnibus bill in the works, I have not seen it yet. But I am hopeful.
- Also, the mental health caucus is approved and it is bicameral and bipartisan. I am optimistic that this will create some momentum and can pass a MH bill every session going forward.
Rep. Dewey McClain – District 100
The lawmaker describes the series produced by 11Alive, as eye-opening and a strong indication that legislators and communities at large need to do more to protect the vulnerable and keep families together.
Representative Dewey McClain has been a fierce advocate and champion for behavioral and mental health reform for years. Mental and behavioral health along with the quest to obtain true mental health parity for all is ingrained in McClain’s DNA, as psychology was one of his three minors along with sociology and government. After viewing the ongoing 11Alive series which delves into the difficulties parents face while trying to obtain mental health services for their children, and why many of them make the heart-wrenching decision to abandon their children and relinquish their parental rights.
According to Rep. McClain, it is lost on many people who are not familiar with the challenges children who can’t process their emotions, control their impulses, or function with developmental disabilities can be. “People have to realize that having a child who is autistic or has any type of developmental disability is just as challenging for parents as well as the child. I can’t imagine how frustrating it would be if I could not access the necessary care for one of my children. Even worse, if I was placed in such a position of desperation to where I felt that the only choice I had was to abandon my flesh and blood and make them a ward of the state, I would be devastated,” McClain said.
Learning that 1,268 children in the state of Georgia have been abandoned and placed into DFCS custody since 2016 because their families could not gain access to behavioral and mental health care is heartbreaking and concerning according to McClain. “It is shocking to learn that the taxpayers are spending $76 million every year to put a band-aid on a failed system of care. Those resources could be utilized to help build a system of care that would serve the needs of the children who are the most vulnerable, and provide their parents and other caregivers the resources, mental and emotional support they need,” McClain said.
The state of Georgia does allocate about a third of its budget to health care, however, Rep. McClain says that the legislative bodies have to do more. “Here is what I know, children being forced out of their family units because their parents can’t access care, means that we have to do more than just throw money at the problem. We have to make fixing the problem a priority. We can start by addressing the fact that the knowledge of the resources that are available is not getting to the Georgians who need it. For example, we have not done a very good job of talking about how the new federal tax credits have lowered the cost of insurance premiums through the Affordable Care Act. Many people in our state have probably not even thought about trying to access an insurance policy through the exchange,” McClain said.
In recent years, the costs have been far out of reach for Georgia citizens because the legislature failed to expand Medicaid. “I just received a call from a constituent who told me that I needed to start talking about the great plans being offered this enrollment period. She added, citizens can choose from 151 plans this year instead of the handful they had to choose from in recent years. My constituent said that she was able to get a policy for $58.07 versus the lesser policy she had to pay $798.00 for last year. These savings are huge for Georgia families and could help many parents access care for their kids. We just have to let people know that they can insure themselves and their families, as many plans have $0 premiums,” McClain continued.
According to Rep. McClain, counties need to work together to establish a uniform directory of resources. “We have to make sure that resources are made available in every county in this state. These are things that must be remedied, and they must be remedied sooner than later. Abandonment only exasperates whatever issues a child is having. In addition, many children who are on the autism spectrum, or have other types of developmental or mental health conditions never fully recover when they experience a traumatic event. I can’t possibly think of anything more traumatic than being abandoned by a parent,” McClain said.
According to Rep. McClain, our nation’s health care system has been broken for decades. “Our nation’s system of care has been limping on a crutch for a while, however, some of the obstacles many families in our state are having to navigate around, were caused by us. When our governor and legislative bodies failed to expand Medicaid, we lost a number of rural hospitals. That has had a major impact on the ability of many to experience the care they need, especially now that we are in the age of COVID. Georgia sits among eight other states including Florida, Idaho, Arkansas and Alabama that have counties where there is not even one doctor to care for citizens.”
There is a severe shortage of mental health professionals in the United States at large. According to the Bureau of Labor Statistics, in 2025 the United States will need 15,400 more psychiatrists, 57,490 additional psychologists, an additional 26,930 mental health counselors and 48,540 additional social workers. “We are in trouble, in terms of being able to keep up with the demand for mental health services. I have known this for a while, which is why my team and I have been talking about the shortage of mental health professionals. As a matter of fact, I approved a piece written by my Chief of Staff which appeared on Everynurse.org to try to create a sense of awareness and urgency in 2019. We have come to the point where we can no longer kick the can down the road, we have to do something,” McClain said.
Rep. Sam Park – District 101
Thank you for bringing attention to this heartbreaking and important issue. We can and we must do better to support Georgia families seeking to care for their loved ones.
I hope mental and behavioral health will be a key topic during the upcoming 2022 legislative session with a specific focus on the needs of children. My understanding is that there is a bipartisan, bicameral mental health caucus forming to address some of these issues next year. I will also continue to advocate for Medicaid expansion which would be a big step toward ensuring access to mental and behavioral health services for Georgians.
Rep. Matthew Wilson – District 80
Thank you for your investigation into these cases. They are truly heartbreaking, and the families impacted deserve a full accounting of the state’s failure to reasonably support parents simply attempting to provide the best possible care for their children.
Although we have come a long way in terms of talking about mental health as a critical component of a healthy life, it’s past time for Georgia to put our money where our mouth is. Georgia is dead last among all 50 states in this for a reason– we haven’t provided access to care as a policy and funding priority.
It’s been encouraging to see this issue attract more attention, especially as the severity of our mental and behavioral health treatment crisis has deepened over the pandemic. I expect the General Assembly to consider legislation aimed at increasing access to care when we resume session in January, and I personally intend to work with colleagues from both parties to ensure that whatever measures emerge from that process actually address the urgent need of Georgia families like those whose stories you’ve been telling. Any real solution must include state enforcement of federal mental health parity protections in private insurance plans and assurance that Medicaid will cover necessary mental health treatment at reimbursement rates that ensure providers can afford to participate.
I am a co-sponsor of House Bill 49, the Mental Health Parity Act, which has not been taken up by the House Insurance Committee that I serve on. This bill would address many of the concerns raised by your series and others. This crisis is not new and is only growing more severe, and the legislative process must not run so long that we continue to leave families in the kind of desperation you have highlighted. I sincerely hope we act on this as soon as possible.
Senators Kay Kirkpatrick and Elena Parent also called to voice their support for the series and reform on these issues.
Dr. Brenda Fitzgerald – Governor's Behavioral Health Reform and Innovation Commission Member
Your work certainly shines a clear light on the many barriers to care our state is currently facing. We have heard a lot of subject matter expert testimony regarding many of these issues. Your work has enabled people from all walks of life to better understand some of the extreme barriers to mental and behavioral health care so many Georgians are experiencing. Your compelling work and the voice of Georgian’s demand that we act on this.
Mental and Behavioral Health parity is important for so many reasons. As a physician and obstetrician, I understand what quality healthcare is. If a patient presented with gestational diabetes, I would treat her for that condition throughout her pregnancy and after. To think of allowing that expectant mother to go into a diabetic emergency before providing treatment would be senseless. This unfortunately is all too common among behavioral health diagnoses. Patients often have to fall into crisis mode before appropriate treatment is provided, and even then it is so often an uphill battle that is never won. Unfortunately, this cycle starts all over again once there is a slight change in their care and the current system often demands a brand new diagnosis. This lack of a continuum of care aggravates the system, increases costs for all involved, decreases care, and mental health stigma is perpetuated. These extreme situations that you highlight are heartbreaking and should never get to the point of crisis mode in the first place. Mental and Behavioral Health parity will help get care to those that need it from the beginning. Georgia needs to move upstream and begin to work proactively rather than reactively. This is a big first step.
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