Letters: Professionals decry cuts at Sagamore

We’ve not been given reasons for the closing of inpatient services at the Sagamore Children’s Psychiatric Center in Dix Hills . They’d better be good, otherwise another door has been needlessly slammed in the faces of children with severe mental illness.

Lip service is paid to “continuum of care,” but children and teens with the most complex psychiatric disorders need more treatment than is possible in outpatient clinics or even residential programs. Children and teens sometimes need several weeks of inpatient care just to get cleaned out from multiple and ineffective combinations of drugs that have blurred their psychiatric conditions. Their parents, who often have their own mental health needs, require understanding of their child’s condition as well as help in ultimately managing the problems.

Alarms are raised about overuse of drugs. In truth, the biggest fantasy is that psychotropic drugs can replace all treatment that seriously disturbed children need.

Mental heath treatment has been transferred to public schools, and it does not belong there. Many insurers pay for inpatient care only as long as a child has a rope around her neck or a knife in his hand. But children with complex emotional, developmental, and/or behavioral disorders need informed, interdisciplinary psychiatric, psychological and psychoeducational treatment not found outside psychiatric hospitals.

I wish a few days of such treatment would do the trick, but for some kids, it just doesn’t.

Closing Sagamore is a shortsighted solution to the state’s fiscal problems. The cost won’t go away. It will merely be transferred and postponed, with the penalty borne on the backs of the most vulnerable.

Dr. Gabrielle Carlson, East Setauket
Editor’s note: The writer is a professor of psychiatry and pediatrics, and director of child and adolescent psychiatry at Stony Brook University Hospital.

I have been working with special education and general education students for 30 years. As an administrator and chairwoman of our committee on special education, I know well how many emotionally fragile, depressed and suicidal adolescents attend our public schools.

These adolescents struggle with myriad psychiatric disorders while trying to manage the academic demands of middle school and high school.

Nearly one in six high school students has seriously considered suicide, and one in 12 has attempted it, according to the Centers for Disease Control and Prevention.

What educators and parents are up against is trying to educate children who engage in self-destructive and self-injurious behaviors that require immediate attention. We cannot expect these students to succeed in any educational placement until their psychiatric and emotional needs are addressed.

Sagamore Children’s Psychiatric Center has provided school districts and parents the opportunity to care for these students until they are well enough to return to a district-based or alternate program. Being located here on Long Island, Sagamore has allowed parents to be involved in a child’s care on a daily basis.

Over the past few years, I have seen a significant increase in the number of students so emotionally fragile that they need immediate therapeutic care. The Sagamore center has been the facility that our committee believed would accurately diagnose and make appropriate pharmaceutical and therapeutic recommendations to help children get well.

I urge the Office of Mental Health and New York State to reconsider closing the Sagamore inpatient facility. Instead of investing so much money on educational assessments and scores, perhaps they should first ensure that our most fragile children have access to the care they so desperately need.

Patricia Hantzidiamantis, Bayport
Editor’s note: The writer is executive director of pupil and personnel services for the Bethpage school district.

As justification for closing Sagamore, the state Office of Mental Health states that more than 50 percent of inpatients come from family court, and this is “not an appropriate use of hospital beds” .

The 50 percent figure is misleading. Youth evaluated at the request of the court generally have much shorter stays than others, and thus they account for only 15 to 20 percent of inpatient bed utilization. These youngsters do have psychiatric diagnoses and have often failed to improve with community-based mental health services. They come to the attention of the family court when their lack of improvement results in school refusal, major conflicts at home or behaviors that endanger their own lives.

To my knowledge, the state agency has never systematically studied these youngsters and their problems, and the decision that “they can and should be served on an outpatient basis in the community” appears arbitrary. At least the agency has, for the first time, offered some explanation for its decision to close Sagamore’s inpatient beds.

Is it fair to take Sagamore away from all who need it because the Office of Mental Health opposes court-ordered evaluations and treatment? I would say not.

Dennis R. Dubey, Port Jefferson
Editor’s note: The writer is former executive director of the Sagamore Children’s Psychiatric Center.