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Center takes new approach to treating mental illness, drug abuse
WASHINGTON (CNN) - Untreated drug addictions and mental illnesses in families underlie at least 80 percent of U. S. cases of child abuse and neglect, according to one expert.
In making this statement, Dr. Johanna Ferman, a mental-health administrator, also cited the lack of coordination in therapy programs administered by officials of various government agencies and private efforts.
"Sick kids wind up in emergency rooms, and parents are put in jail," she said. Efforts to treat underlying problems of a particular family with sick kids and a jailed parent are typically uncoordinated since "that's how the financing works," she said.
Policy makers at the federal, state and local levels should design programs and funding paths that address the whole family suffering from drug addiction and mental illness, said Ferman, chief executive officer and medical director of the Center for Mental Health Inc., in Washington. Its method of treating patients is gaining national attention.
"The goal of the systemic approach is to change the landscape of high-risk children and high-risk adults," she said. This includes breaking the cycle of untreated addiction and mental illness, of disability and poverty.
"For too many children, this cycle is a slow march to prison or a mental institution," said Ferman, who was a New York state deputy commissioner for mental health in 1983-88.
The Center for Mental Health that Ferman now directs is not a government facility. It is an independent, nonprofit organization. Most of its $7 million annual budget comes from Medicaid (largely federal funds), contributions from local and national foundations and private donations.
Addiction seen through a child's eyes
As part of the unified approach, mothers being treated for drug addiction or psychological disorders bring their children to the center. This also solves a major obstacle -- what to do with small children while a parent participates in therapy.
At the center directed by Ferman, children suffering emotional and physical damage are given therapy. Abused children often have difficulty using words to describe their fears and hopes, Ferman said.
"Children are more comfortable expressing themselves by art -- visually, nonverbal -- dancing or drawing a picture," she said.
Kids from troubled homes often depict violence in their drawings, someone hitting another, Ferman said. "So art is a way to gain access to a child's feelings."
Many of the children have been abused or neglected by parents strung out on drugs.
In her mid-30s, Connie Brooks has given birth seven times. At one point, six of her children were taken from her because of her drug-related problems. At the Center for Mental Health, Brooks, a single mother, has cared for her seventh child and learned about responsibilities.
She wants to become "a role model to my children -- because they know where I used to be, and they know where I am now."
She has custody of four of her six remaining children, said Ferman, adding that one of the seven children was killed in narcotics-connected violence.
In group sessions at the center, emotional confessions are common. One woman admitted that her children cried because they were hungry. "I had used the money for groceries," she explained, "to buy drugs."
'Living in a war zone'
Mothers have group therapy and individual assessments to diagnose mental illnesses. Depression and anxiety disorders may combine with other mental or physical problems, leaving the mother unable to care for her child, said Ferman.
Like soldiers returning from combat, "some of our patients have, in essence, post-traumatic stress syndrome," Ferman said. In their urban residences, "they've been living in a war zone."
Tens of thousands of patients have been treated at the Center for Mental Health since its founding in 1966. It is not a residential facility and about 350 people are seen on an outpatient basis each day, said Ferman.
"We treat the parent and the child under the same roof," Ferman said.
Staff members at the center annually serve about 1,500 patients. Depending on severity of the addiction or illness, a patient may receive treatment from 20 to 200 days a year. Also, Ferman said, about 500 members of patients' families attend classes during a year.
Addiction's root causes
Many of the parents who are patients at the center have a troubled relationship with alcohol and a wide assortment of unlawful drugs.
Marijuana, Ferman said, is a "drug of destruction." It can produce in habitual users a loss of motivation to study, to work, to care for children.
Addicts who are depressed may use cocaine or crack for the stimulation to the nervous system -- the "up" those drugs give, Ferman said. "A manic-depressive may use alcohol, which is a depressant."
She said, "Addiction has three root causes -- biological, social and psychological. Often there is a family history of addiction, which gives the children a genetic tendency to abuse drugs. They are not bad people. They have, in part, inherited it.
"And second is the social part of addiction. You take drugs for peer acceptance and to satisfy peer pressure. We want our patients to understand and be able to say, 'I need to become stronger in myself and seek other social settings and other social groups.'
"The psychological root cause often involves the patient's children and other members of her family. Sometimes a problem is caused by family members acting as enablers," taking care of small children, thus enabling the parent to find drug-using social groups, she said.
"Treating the family unit is important," said Ferman. "Addiction and recovery programs that are successes treat all three root causes."
Measuring the effectiveness of mental-health programs means checking on patients after their release or completion of a program. Follow-up interviews occurring six months later, then once a year for several years, are very desirable, Ferman said.
She said the center's treatment approach -- an "integrated services model" -- reduces hospitalizations, residential and institutional care, child abuse, school dropouts, use of illegal drugs and alcohol, with fewer children taking "special education" or remedial classes, parents passing high-school equivalency tests and getting jobs and "coming off of Medicaid."
A team from the University of Illinois is studying the methods and results of the integrated program at the Center for Mental Health and three other treatment facilities in the United States. The team's report is expected next year.
CNN Correspondent Eileen O'Connor contributed to this report.
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