18. ADOLESCENT MENTAL INSTITUTIONS -- BIG PROFITS, BIG MISTAKE

The summer camp/boarding schools of the '90s may well be adolescent mental institutions where parents can commit their rebellious, difficult children.

This is Reaganomics-style mental health care. Those who can afford it get it. In California, changes in the state law have made free market conditions -- not need -- the criteria for building new facilities. The fierce competition to fill beds has pushed hospitals into aggressive marketing -- selling mental health like so much laundry soap.

In the last ten years, teenage psychiatric hospitalization has increased between 400 and 500 percent. This reversed an earlier trend which had favored outpatient, community-based care. However, because most insurance policies severely limit coverage for outpatient therapy, hospitalization has become the only "affordable" form of treating the problem.

While beleaguered public mental health clinics that serve low-income patients are shutting down and scaling back on services, private hospitals are making millions.

The San Francisco Bay Area is attracting an increasing number of these new profit-making institutions. The Community Psychiatric Centers, a Laguna Hills-based hospital chain which operates the Walnut Creek Hospital in the Bay Area, plans to open three new facilities in the area. Georgia-based Charter Medical Corporation, which last year became the first psychiatric hospital chain to top the billion-dollar mark in annual revenue, also is planning to open three hospitals in the area. And Century Health Care, based in Oklahoma, has opened the Oak Grove psychiatric center, which specializes in adolescent care, in the East Bay area.

Parents can commit their children to mental hospitals without their consent. The child is often put on medication and goes through extensive psychological counseling.

To the parent, the private hospitals provide an alternative to juvenile hall; to the adolescent, they are branded insane; but to the hospital chains they spell enormous profits.

Many of the young patients need therapy, some experts say, but not hospitalization. In fact, some critics say that the institutions worsen the situation. In some cases, adolescents get addicted to the highly-structured "safe" life of the mental ward. Kids that are dragged in kicking and screaming, committed against their will, are sometimes scared to leave; even after being released, some kids have actually run away ... back to the mental institution.

One analysis of mental health costs to large employers revealed that while the number of adult hospital admissions over the last decade has remained relatively constant, admissions for children and adolescents have risen sharply -- especially in private hospitals. One company studied had spent $1.5 million one year on 23 cases, an average of $65,000 per case. Twenty-one of the 23 cases were for the children of employees.

The trend may be reversed by insurance companies and self-insured corporations which now foot the skyrocketing costs for the mental health care of employees and their families.

SOURCE:

IMAGE, 4/10/88, "Cleaning Up," by Don Lattin, pp 26+.