Lakeshore Hospital serving children well despite state cuts in mental health funding

Chicago Lakeshore Hospital is one of the last acute care mental health safeguards in Illinois, and it serves roughly 25 percent of the children who are wards of the state needing mental health care.

Across the United States, access to mental health and substance abuse services are severely lacking. There must exist an outlet, such as Lakeshore, for treating the most acute, symptomatic population of our community.

Otherwise, our patients end up in alternatives that are unacceptable — such as jails, the juvenile detention system, substandard and unspecialized general acute hospitals — or they go untreated in the foster home system and homeless population.

It is a cycle we strive to break every day, and it is complicated.

To simplify the acuity of the mental illness of our patients or indict the care we provide demonstrates a lack of understanding, which can be counter-productive to improving mental health services in Illinois.

Illinois has suffered a reduction of 450 beds in residential treatment facilities. Combine that with cuts to psychiatric leadership grants, which fund many local treatment providers, and Illinois is unable to address the basic mental health needs of its residents. This systemic problem also includes dismal funding for neonatal services and early education programs for low income families.

Illinois routinely ranks at the bottom of the list for states funding these resources, and it has one of the lowest Medicaid reimbursement rates in the country. Lakeshore is one of the only large-scale, acute care mental health hospitals that has not been forced to close due to Illinois’ dismal funding.

The patients we treat often have a history of trauma and neglect and are prone to increased incidents of acting out. Healthcare providers know that such patients, who often are physically and emotionally volatile, are difficult to treat. That is why many simply refuse to do so.

Unlike other providers, Lakeshore has continuously filled the need and made a commitment to serve as a safety net for children who are wards of the state of Illinois. Every allegation of abuse or neglect, regardless of the probability, is taken seriously, reported to DCFS, and immediately investigated. In all the allegations that have been reported recently, none have been classified by DCFS as founded.

Our doctors and staff specialize in acute child and adolescent psychiatric care on a short-term basis. If a patient is kept in an acute setting longer than medically necessary — for lack of an alternative placement — patients may regress and their treatment may suffer complications directly related to unnecessarily long hospitalization stays. We have, to no avail, advocated for better state funding to solve placement problems.

One of the professionals who testified in August before a committee of the Illinois General Assembly, advocating for more and better services for Illinois’ youth, was Dr. Peter Nierman. He is Chicago Lakeshore’s medical director, an assistant professor of child and adolescent psychiatry at the University of Chicago, and past director of Children’s Services in the Office of Mental Health at the Illinois Department of Human Services.

According to Dr. Nierman:

“The idea of taking DCFS youth out of Chicago Lakeshore Hospital, as the ACLU has recommended, is recklessly ignoring the reality that such an action would eliminate access to care for this population entirely. These children are actively being treated by an outstanding clinical staff that is second to none in the City of Chicago.

“We have patients referred to us across the state, bypassing many closer hospitals, because other providers either do not have the capacity or the willingness to treat these children desperately in need of psychiatric care. Lakeshore’s commitment to working with this population is steadfast.”

Funding for community mental health programs has been dramatically reduced, largely because of the two-year state budget impasse that began in 2014. Illinois has defunded community mental health programs and created gaping holes in the overall spectrum of mental health care.

Community mental health programs are vital partners. By eviscerating them, the state puts more pressure on hospitals as the only resource.

We are mightily trying to do our job. When will the state of Illinois do its job and properly fund this important work?

David Fletcher-Janzen is CEO of Chicago Lakeshore Hospital.

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