Saturday Mailbox

SATURDAY MAILBOX

October 20, 2007

Let's fund the care kids need to flourish

In telling the tale of the tragic death of Davon Qualls, The Sun's article "Failed by the system - taken by the streets" (Oct. 14) puts a name and a face to our nation's failure to adequately fund effective mental health services for youths.

This senseless death is upsetting but not surprising.

National data show that only one out of three children with a serious emotional disturbance receives needed mental health services, and for those who do get services, help often arrives years after the onset of illness.

In the interim, many of our youths fall into a downward spiral of school failure, low self-esteem, alcohol or illicit drug use and involvement in gangs and street life.

Ironically, an intensive, home-based intervention that targets antisocial behavior among adolescents like Davon recently became available to a limited number of Baltimore youths.

Multisystemic therapy attempts to modify a variety of factors that contribute to antisocial behavior. It has been demonstrated to be more effective than either traditional mental health treatment or detention in reducing rearrest rates among youths.

The critical question is whether we can secure funding so that multisystemic therapy can be offered to the many youths who would benefit from it.

One key is Medicaid, which covers this treatment in several states but does not do so in Maryland.

Our state is currently exploring ways to fund such treatment under Medicaid.

But at a time when the federal government is trying to pull back on Medicaid funding for mental health services and the state is facing a significant budget shortfall, it will take a strong and creative effort to improve the availability of this and other effective mental health interventions for our city's youths.

Davon's death should remind us of the choice we face.

Either we as a society commit ourselves to finding resources for effective community mental health services, or children like Davon will continue to pay with their lives.

Jane D. Plapinger Benjamin Mason Baltimore

The writers are, respectively, the president and CEO and the chairman of the board of Baltimore Mental Health Systems Inc.

Back the better bill on gang prevention

The editorial "Think prevention first" (Oct. 15) did an excellent job explaining how our current approach to gangs is lopsided and ineffective.

Bills such as Sen. Dianne Feinstein's are fundamentally flawed because of their emphasis on punishment and incarceration, and would only increase the well-documented problems of racial and ethnic disparities in the imprisonment of youths in the juvenile and criminal justice systems.

One positive, effective alternative is the Youth PROMISE (Prison Reduction through Opportunities, Mentoring, Intervention, Support and Education) Act, which was introduced recently by Rep. Robert C. Scott of Virginia.

Rather than press ineffective gang-suppression techniques that end up putting more black youths in prison, this bill would help build on methods proved to reduce youth violence and delinquency.

Under the Youth PROMISE Act, communities facing the greatest youth gang and crime challenges would receive targeted funding, training and technical assistance to develop and implement a comprehensive plan for prevention and intervention strategies targeted at young people and their families, including increased witness protection and youth-oriented policing.

This bill would do more to make our communities safer, reduce victimization and help at-risk young people lead law-abiding and healthy lives, free from gangs and other criminal involvement.

Tara Andrews

Washington

The writer is deputy executive director of the Coalition for Juvenile Justice.

Drug tests on kids ethically unsavory

There are several ethical points at issue when we consider clinical drug testing on children ("Untested medicine," Oct. 16).

Whose child will be the guinea pig? What is a child's life worth? How much risk is acceptable? And should the parents or guardians of a child who sustains damages or death in a drug trial be considered abusive for endangering the child in the drug test?

But the larger issue is that the concept of "informed consent" in medicine assumes that the participant in a test has been informed to his or her satisfaction about the drug being tested and the purpose of the test, made aware of the risks and possible adverse reactions and understands that there is no guarantee of the efficacy or safety of the drug tested.

A child is not competent to give informed consent to participate in clinical drug trials (although the parents or guardians may do so on the child's behalf).

Yet the physical burden of the testing, including any loss from injury or death, will fall squarely on the child.

The child who cannot decide for himself or herself must then permanently bear the consequences of a life-changing decision made by trusted adults.

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