Study questions New Mexico spending on traumatized children

SANTA FE, N.M. (AP) — New Mexico is spending enormous amounts of money in potentially ineffective ways to treat a relatively small number of children for mental health problems related to household trauma and depression, several state agencies announced Wednesday in a report presented to lawmakers. The study showed that over a three-year period, New Mexico spent an average of $60,000 a year per child in Medicaid funds to treat 190 patients with acute behavioral conditions. Costs linked to those severe conditions dominated the state's spending on children for behavior health problems — making it more difficult to invest in preventative programs that can keep children out of the juvenile justice system and foster care, the study found. Maria Griego, a program evaluator with the Legislative Finance Committee, said $89 million out of the $196 million spent on children's mental and behavior health went to acute interventions largely at away-from-home facilities such as psychiatric hospitals and residential treatment centers. "Keep them in their homes, in their communities — the outcomes are better," Griego said. "It is a more cost efficient way to handle children's behavior health." The state treats more than 43,000 children for behavior and mental health issues. Residential treatment programs for just over 1,000 children consumed an average of $42,000 per child. "Residential treatment is an area that has been studied more than any other area for kids and it's consistently been demonstrated that it doesn't get the results," said Wayne Lindstrom, director of the state's Behavior Health Services Division. Efforts to shift spending to behavior health programs that keep children close to home and active in their communities have been hampered by a lack of data and monitoring. The study looked at the cost effectiveness of dozens of state- and federally funded programs, from juvenile drug courts to games introduced in New Mexico public elementary schools to decrease disruptive behavior. National studies have highlighted the financial strain of treating a small number of children for acute mental health and behavioral problems. A 2013 study of Medicaid-enrolled children found that 4 percent of behavioral health patients accounted for 19 percent of costs. In New Mexico, officials said mental-health treatment spending on children has gravitated toward traumatic stress and mood-related disorders often brought on by household strife, and away from traditional psychiatric conditions. Children in New Mexico were more likely than peers nationwide to witness domestic violence or be the focus of physical and mental abuse, the study noted. Above average rates of poverty, substance abuse and domestic violence put children in New Mexico at a relatively high risk of mental health problems. Teen suicide death rates in New Mexico are double the national average. The state has been shaken by a series of child-abuse related killings, including the slaying last August of 10-year-old Victoria Martens. Sen. Gerald Ortiz y Pino said expensive residential programs still have a place in the state's behavior health portfolio for children. "If after three years at $150,000 they go to college, get into the Air Force, start a family, are a good father, then that's money well spent," he said.