Since the 2012 massacre at Sandy Hook Elementary School, society has been discussing mental health, specifically eradicating stigma and ensuring ready access to quality community-based care ["Newtown's mental health needs," News, March 17].

Seventy-five percent of serious mental illness occurs before the age of 24, and half before the age of 14. Yet, only one out of five children who has an emotional disturbance receives treatment from a mental-health specialist.

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In New York, continued access to care is assured only to children and families with Medicaid coverage, because reimbursement from commercial insurance is far lower and many providers will simply not accept it. The state Office of Mental Health has established a multi-year vision for the mental health system called Regional Centers of Excellence, which does not change the reimbursement formula. This will continue to marginalize community-based care for middle-class or working-poor families that have commercial health insurance.

Community clinics are the last bastion in addressing the needs of children and adolescents with serious emotional disturbances. Private psychotherapists and child psychiatrists, with some exceptions, will not accept commercial health insurance or will not provide the costly, labor-intensive work necessary to properly serve children and families struggling with serious emotional disturbances.

Andrew Malekoff, Long Beach

Editor's note: The writer is the executive director of the North Shore Child and Family Guidance Center in Roslyn Heights.