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Charlotte Amalie
Thursday, December 7, 2023


I have worked in the arena of children's services for more than 23 years and I remain concerned about the absence of comprehensive mental health services for children in the Virgin Islands.
Not only is there a notable absence of these vitally needed services, but what is available is underfunded and understaffed.
I returned home to work as a social worker in 1972 and was then disturbed about the absence of viable services for emotionally disturbed children.
At the time, because there were no residential programs geared to meet the needs of these children or their families, they were lumped together with delinquent or abused children. However, at least there were good outpatient services available.
Today, we do have a short-term crisis facility for children on St. Croix, and this somewhat addresses the need, but there is still no acute-care facility for children or young people who need hospitalization.
Oftentimes, due to this lack, children or young people whose parents take them to the hospital, and who need hospitalization, are medicated in the emergency room and then sent home with parents who most likely have no training or ability to respond to their child's mental health issues. We have seen this result in teen suicides that potentially could have been prevented.
Of particular concern is the fact that the absence of the less costly mental health counseling services often results in the need later on for institutionalization.
Other times case studies, I believe, of many of our homeless mentally ill, would show that they did not receive the counseling they needed when they were younger and first exhibited symptoms. Many of them are doomed to being street people and subject to abuse or to abusing others, for the services for the adult mentally ill populations are perhaps even more limited.
The mentally ill poor child is the one least likely to receive the preventive or early treatment that is so vital to his or her adult well being.
In fact, generally, the only children who receive appropriate early intervention are those whose parents have insurance and know how to access health care. Even then this is troublesome, because while many insurance companies pay 80 percent of the cost for medial care, they only pay 50 percent of the cost for mental heath care.
Additionally, in many policies mental health care has an absolute maximum on the amount paid by insurance companies that is but a fraction of the absolute on medical care. Given the cost of mental health care this can be prohibitive for those without deep pockets.
It is my hope that one day there will be recognition that early intervention and prevention of mental health problems are not only in the best interests of the individual but also to the general quality of life of the community of the Virgin Islands.
It is not a casual coincidence that youth violence is increasing year after year. I am of the opinion that the absence of a comprehensive mental health system is a significant contributing factor.
Editor's note: Catherine L. Mills, a former Human Services commissioner, has a master's degree in social work.

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