Report on 19th Annual Rosalyn Carter Georgia Mental Health Forum-May 16, 2014
Tuesday, June 03, 2014
Posted by: GPA Staff
*GPA Member Betsy
Gard, PhD attended the event as a GPA representative.
The Forum consisted of three panels. The first panel provided an update on
Georgia’s progress in Year 3 following the Department of Justice
Settlement. The second panel presented
the state of ADHD care in Georgia. The third panel examined the current status of the mental health workforce in Georgia.
In the first panel, the Georgia
Department of Behavioral Health and Developmental Disabilities reported that
there has been significant progress and they have met goals in their Mobile
crisis teams, Intensive case Management Teams, in Supportive Employment
Programs, in Intensive Case Management Programs, in Peer Support Programs, in
Crisis Respite Apartments, and in Crisis Service Units. They are continuing to work on Supported
Housing. There are continuing needs to
work with those who have Developmental Disabilities to meet their needs as laid
out by the Department and DOJ.
In the 2nd Panel, a report was made on the state of children
and ADHD. ADHD is the most prevalent mental disorder in children and was found
to be diagnosed nationwide in 11% of children aged 4-17 in 2011. 8.8 % were found to have a current diagnosis
in 2011. In Georgia, we were found to
have a slightly higher prevalence of 9.2 %. The greatest concern was raised over the diagnosis and treatment of
ADHD in very young children, under the age of six.
This was then reported on in the New York Times on May 16, 2004.
“The American Academy of Pediatrics standard practice
guidelines for A.D.H.D. do not even address the diagnosis in children 3 and
younger — let alone the use of such stimulant medications, because their safety
and effectiveness have barely been explored in that age group. “It’s absolutely
shocking, and it shouldn’t be happening,” said Anita Zervigon-Hakes, a
children’s mental health consultant to the Carter Center.
“People are just feeling around in the dark. We obviously don’t have our act
together for little children.”
“Particularly given that there is still a debate among practitioners
and researchers regarding whether ADHD has a biological basis, or is a label given to a collection of symptoms,
diagnosis among very young children of a disorder based on symptoms that can be
considered typical of many young children (short attention spans, talking a
lot, unusually active and noisy, prone to disregarding instructions to remain
still) is difficult at best. A diagnosis solid enough to use as a basis for
prescribing stimulant medications, which have not been proved safe or effective
for that age group, should be nearly impossible to come by. Judging by the
numbers, under certain circumstances, that isn’t the case.
Medication for some toddlers can seem like a cheap and fast fix, and
one that parents who are probably already struggling may welcome. Many toddlers
on Medicaid live in single-parent homes, where the time to put into alternative
programs may be as scarce as the programs themselves.
It was recommended that behavioral therapy be the 1st
therapy approach for young children that only if behavioral therapy is
ineffective, that medication be considered for moderate to severe disturbances
that do not significantly improve.
the 3rd panel, the discussion focused on the problems with the
inadequate number of mental health work force that is available in
Georgia. The following ranking were
found for Georgia across the different disciplines:
of Behavioral Health Professionals per 100,000 in Georgia
and Family Counselors—31st
Advance Practice RNS -28th
then focused on what can help in the future with Work Force Challenges. These included; using multidisciplinary teams
to provide services. We will also need to use data to improve practice, make
sure we employ a recovery based approach, try to increase the diversity of the
health care providers to more match the population of those needing care, use
telehealth and technology to extend our reach to meet those in rural
populations, and use stepped care models for better systems of care.
We also need
to provide more systematic career ladders and have better leadership
development. We need to provide better
supervision models and assure that an incompetent service system does not
thwart competent workers.
suggestions were made from the ACTION PLAN FOR BEHAVIORAL HEALTH WORKFORCE