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USF study identifies mental health care gaps in Sarasota

The Herald-Tribune - 3/27/2019

March 27-- Mar. 27--SARASOTA -- Often the symptoms of mental illness for children and young adults go unnoticed, until all it once, they strike like a tsunami.

Ronni Blumenthal says her daughter's social trouble was overlooked until it all crashed in middle school. She blamed herself for bad parenting, but what she really didn't understand was the dynamic challenge her daughter faced among her peers during her daughter's early years.

"My daughter has always done well academically, but socially she struggled," said Blumenthal, who spoke during a panel discussion on mental illness Tuesday night at The Academy at Glengary. "I think, not really understanding the degree to which she struggled socially -- we don't really see our kids in the school setting. I don't think teachers really look closely at social skills and how big of a part that plays in development. They are really focused on the academic piece."

The Charles and Margery Barancik Foundation and Gulf Coast Community Foundation commissioned the University of South Florida to conduct a scan of mental health services in May 2018. The goal was to identify strengths and gaps in the system and prioritize ways to make the system work for youth and families.

They released the results Tuesday at an invitation-only event that included law enforcement, physicians, mental health experts and community leaders. The study revealed the annual economic cost of untreated mental illness for children and young adults in Sarasota County is nearly $86.2 million -- a number John Robst, a research associate professor with the Department of Mental Health Law and Policy and Department of Economics at USF, calls the minimum cost.

"The $86 million sort of incorporates the victim in a sense -- the single victim," said Robst, who was one of three USF professors who worked on the study. "It ignores everything around them. It doesn't count the impact on a family member. How do you value the loss of a child? It's impossible."

The primary drivers of the cost are suicide, criminal justice, education and worker productivity.

Blumenthal says she found it difficult to find good, sustainable quality services for her daughter.

"If you're rich you can get great services," the frustrated mother said. "If you don't have the assets then you are fighting against a public system that kind of is just pushing at you to take your kid home because they don't have the resources.

"I can't tell you how many times, from the time my daughter came back to the community, I just kept saying, home is not going to be OK. She needs structure, she needs staffing, I can't do this alone, and there was nothing. Just nothing."

Blumenthal said there were a lot of people who tried to help, but there was often a break between support and services.

The USF report found inter-agency collaboration was high, while skilled provider networks appears to be low. When it came to actual care, there was a willingness to help, but also high levels of untreated mental illness among youth.

Robst said few studies have been done about mental illness at a local level. His searches found data on the costs at the local level, but very little about untreated mental illness.

"It's hard to grasp that," Robst said. "Children in particular, it's tough to find research on ... surprisingly enough, considering the cost of treating a child is much greater than adults."

Roughly 15 percent of Sarasota County's residents are under 18 years old, or around 60,488. About one in five experiences a severe mental disorder during their life. Half of all chronic illness begins by the age of 14, and three-quarters by the age of 24.

Sarasota County Judge Erica Quartermaine, a guest speaker, said about 60 percent of those who are incarcerated suffer from mental illness that could have been helped with early intervention.

"The amount of time I spent studying the statistics, there is one conclusion: the younger a person is, the less amount of time that person has experienced homelessness and the less time that person has self-medicated with street drugs," Quartermaine said.

Florida ranks 50th in mental health services, according to the Florida Policy Institute. The state has the third-highest percentage of mentally ill persons who are also uninsured.

In 2014, the state provided just $36.05 per person in support of mental health services, less than one-third of the U.S. average of $125.90.

Some of the services that are lacking in Sarasota County include inpatient care, residential treatment programs, independent living options for adults, case management, post-discharge services from crisis stabilization units, and youth psychiatric treatment, the study said.

USF attempted to recruit 105 primary care providers to participate in a survey, calling, visiting their office and extending the response time, but only two participated.

Norin Dollard, an assistant professor in the Department of Child and Family Studies and director of Florida Kids Count, says the low response is important information.

"We put in a monstrous effort," Dollard said. "In the end, what we did was we combined the responses from them with the responses to other stakeholders in the community.

"The fact we only got two is still really important information. It means we're really not engaging physicians and they are really the front door especially where kids are concerned."

Dollard said providers participating in mental health is a key to screening children and young adults in need of mental health treatment.

Teri Hansen, the president and CEO of the Barancik Foundation, said the USF study is only the beginning of their effort to create a system for kids.

"This study we are going to act on, we are going to be tireless and fearless in making sure we create that system for these kids," Hansen said. "We just drew the starting line in the sand today. This is the start and it will take a long time, but together with our partners we will get there as they all take ownership of their pieces. We have the time and we have the money to do it."

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