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Hillary Clinton, Unicorns, and Child Mental Health Care

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“Good child psychiatrists are like unicorns,” one of my child’s therapists told me last year.

Lucky us. We found one! A unicorn!

In fact, ours qualifies as an extra sparkly, rare unicorn. Because not only does he exist and see my son… this child psychiatrist actually communicates with kiddo’s teachers. He attends team meetings with kiddo’s social workers and therapists. The man has responded to me on a weekend when my son was in the ER and has called me from a vacation to check on us.

But Hillary Clinton just reminded me about how difficult it was to find this wonderful unicorn. And that way too many families out there are still looking.

In our case, to find a unicorn, all it took was:

  • Two years of searching
  • Five psychiatric hospitalizations for a 7-year-old
  • Calls to nearly 40 different child psychiatrists (most of whom never returned the call)
  • Advocacy, help, and failed referrals from seven social workers and an insurance company case manager
  • A great deal of extremely alarming and dangerous behavior that put my son and our family at risk
  • Sleep disruptions that included over a month of our son waking for the day at midnight
  • A six-month waiting list for an appointment with a hospital program that specialized in the type of acute mental health challenge my son faces. Which was cancelled the day before it was to take place. Because while we waited six months for the appointment, my son was hospitalized again and they now considered him too acute. Too acute to be seen by practitioners who supposedly specialized in kids with acute mental illness.

All of this took place, I should add, in the Boston area. Many recognize this community for its relative density of doctors, hospitals, and mental health professionals. And I have a network that includes medical school deans and nursing staff, all of whom were putting a word in for us with various offices.

You know what else? Having dedicated hundreds of hours of my time and effort to unicorn-searching, I can’t even take responsibility for our finding him.

The only reason we found an exceptional child psychiatrist, one actually experienced treating children with my son’s profile, is because we also lucked out big-time with kiddo’s public school placement. Our public school system happens to have a phenomenal elementary school program for kids with emotional and behavioral disabilities. Turns out this program is also something of a unicorn.

The social worker who runs the therapeutic side of it happens to have deep experience in child mental health outside the public schools. And lots of great relationships and knowledge. She is yet another unicorn!

This dedicated social worker cherry-picked the psychiatrist who conducted our school district’s psychiatric evaluation of my son last year, knowing full well we were desperately in need of someone who could work with us long-term. She chose this psychiatrist specifically because she hoped he would be willing to work with us after the evaluation. And she was an incredible advocate for my son’s needs with our school district during the evaluation process. Had it not been for her, I feel reasonably certain we’d now be in year three of looking for a child psychiatrist.

So perhaps this confession won’t surprise you:

My eyes got leaky when I read the brief on Clinton’s campaign website outlining her approach to mental health care.

The brief includes a whole bunch of policy initiatives. But here’s where she gets me, and convinces me she’s really paying attention. As in, she gets me 100% on board with her plan and she also gets me. One mother to another, her proposal communicates that she has some inkling of what I’ve gone through:

“Launch a nationwide strategy to address the shortage of mental health providers.”

When I got to that line, I felt a bit tempted to do a cartwheel in my living room. No kidding. But then:

“For example, there are only 8,300 practicing child and adolescent psychiatrists today, which is one provider per 38,000 children.”

Staggering. Just so difficult to comprehend. And yet – so helpful in understanding my own experience trying to take care of my son. And an additional problem: only a small number of those child psychiatrists are actually experienced with acute mental illness. And only some of those stay current with complex psychopharmacological research.

So for a family whose child has complex mental health needs, the shortage becomes even more pronounced and insurmountable.

Clinton’s mental health care policy brief represents the biggest unicorn of them all: comprehensive public policy that actually addresses the breadth and depth of the growing mental health care crisis in our country.

Image: Former Secretary of State Hillary Clinton speaking at the Brown & Black Presidential Forum at Sheslow Auditorium at Drake University in Des Moines, Iowa. | Credit: Gage Skidmore

Originally published: September 14, 2016
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