Some give up children over mental health care costs

Monday, April 1, 2002

JEFFERSON CITY, Mo. -- Unable to afford mental health care for their children, some desperate parents are relinquishing custody to the state to ensure they receive treatment, advocates and state officials say.

It's a drastic step that could be avoided, experts say, if the state Department of Mental Health were better funded. The department says it can afford to treat only 20 percent of the 53,000 Missouri children it estimates would qualify for services.

But another state agency -- the Division of Family Services -- is required by law to provide health treatment for children in its custody.

And it is to that agency that parents of children with bipolar disorder, depression and other severe emotional conditions sometimes look when private insurance or the Mental Health Department shut them out.

While no hard numbers are available, the Division of Family Services estimates 500 children are in its custody because their families could not otherwise provide mental health care.

That's about 20 percent of all the children that the division has in its special foster care and residential treatment facilities.

Donna Uhlmansiek, of St. Charles, was shocked when a private hospital worker suggested in 2000 that she and her husband go to court and turn their child over to state custody.

At the time, their 10-year-old son was being treated for bipolar disorder and mild retardation. Uhlmansiek and her husband both had insurance that covered mental health treatment, but like most private plans it provided just 30 days of inpatient care.

'We were hopeless'

Unable to stomach the idea of giving the boy up, the couple searched in vain for an alternative.

"We had no place to go. We had exhausted every agency, every place that we were aware of. We were hopeless," Uhlmansiek recalled, her voice quavering as she spoke. With their son's severe emotional disorders worsening, they finally concluded they would have to relinquish custody.

It was just by chance that when they went to the courthouse, they met a court officer who succeeded in admitting the boy to an affordable hospital where they had tried to place him for two years.

Officials say those most likely to find themselves in that situation are the working poor and middle-class families who earn too much to qualify for state Medicaid and cannot afford doctors and hospitals when insurance falls short.

"If a family needs help, the only way they can get if they don't have primary health insurance is to give up custody," said Judy Finnegan, who oversees the Mental Health Department's work with children and teen-agers in the St. Louis area.

For the state to take custody of any child, a judge must decide that the parents are unable or unwilling to provide proper care. In some cases, the parents are charged with abandonment or neglect.

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