In 2007, King County voters approved a one-tenth of 1 percent sales tax to support Mental Illness and Drug Dependency (MIDD) community treatment and diversion programs. These would not only improve care for ill individuals but also minimize the high costs of using corrections and emergency-medical personnel as the default responders to people caught in chemical-dependency or psychiatric crises.
Ten of the 37 strategies for new and expanded programs originally planned for MIDD funding were to address problems of children and youth, directly or indirectly. Such investments, according to economists such as Nobelist James Heckman, have a higher rate of return for society than investments in schools or even in highly-regarded stocks.
Medical research also confirms the prudence of providing systematic help to children who live with the trauma of family violence, drug addiction, alcohol abuse, and homelessness, because it reduces not only their emotional and social disorders in adulthood, but also their physical illnesses.
Despite such encouraging outcomes, a March 28 progress report from the MIDD Oversight Committee shows that new and expanded programs for youngsters in King County were disproportionately scaled back during 2009-2010.
Reductions in many planned MIDD services were necessary because revenue declined in the economic downturn, and 30 percent of available MIDD dollars were used to backfill cuts in the county's general fund, for existing services upon which MIDD programs are being built.
Even with cutbacks, says the report (online here), jail bookings and days in jail for people with psychiatric or addiction disorders were successfully reduced between fall 2009 and fall 2010 by more than 23 percent, while psychiatric crisis hospitalizations decreased 19 percent. These reductions correlate with increases in the number of people receiving thriftier, high-quality care from improved community treatment programs.
But cuts to programs for youngsters went deep, forcing the postponement of programs to improve the parenting skills of people with substance abuse issues; to prevent children of abusers from becoming addicted; to establish a reception center with coordinated services for youth (where police could bring kids in crisis); and to expand the Children's Crisis Outreach Center, which offers stabilization and in-home services to King County youngsters and families in dire straits.
In sum, MIDD suspended four of the 10 programs in its “Youth” category in 2009-2010. Put another way, four out of the six programs placed on hold were ones that had been designed to meet youngsters' needs.
The MIDD committee's reasoning, according to a September 2009 briefing by the council's Regional Policy Committee, was that the four programs were less developed than the adult programs. Amnon Shoenfeld, who directs the King County mental health services division and serves on the MIDD oversight group, said that it was more fiscally responsible to postpone programs that were only in initial stages, and that youth services have perennially lagged behind services for adults.
“We hated not starting the programs for parents who abuse drugs and the drug-prevention program for children,” he said. But these, like the youth reception center, were in an embryonic state. To deal with the money squeeze it was better to delay new programs than “cut existing programs and waste the money you used to set them up.”
Programs for children in crisis are one of society's best bargains, says University of Chicago professor Heckman, awarded the 2000 Nobel Prize in economics. He cites research demonstrating that expensive social problems such as crime, teen pregnancy, school dropout rates, and poor adult health are tied to levels of skill and ability that were stunted in early childhood. Stressing the importance not only of cognitive skills but of what he calls soft skills, Heckman says “perseverance, attention, motivation, and self-confidence contribute to the success of society at large.” And all skills suffer in the children of families in prolonged crisis.
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