HD34 - Report on the Relinquishment of Custody for the Purpose of Accessing Behavioral Health Treatment


Executive Summary:
The issue of parents being faced with the choice of giving up custody of their child with severe emotional disturbances solely to obtain behavioral health treatment is a serious and significant problem in Virginia and the nation. A publication of the Bazelon Center for Mental Health Law calls this problem "the tragic result of failure to meet children's mental health needs." The President's New Freedom Commission on Mental Health recommends the "elimination of conditions under which parents must forfeit parental rights so that their children with serious emotional disturbances can receive adequate mental health treatment." Based on widespread concerns within the Commonwealth regarding this issue, the 2004 Session of the Virginia General Assembly directed that:

"The State Executive Council for the Comprehensive Services Act shall investigate the reasons leading to the practice of parents relinquishing custody of their children solely to obtain necessary and appropriate mental health services. The State Executive Council shall recommend policy options, including legislative action if appropriate, for abolishing this practice while continuing to make the services available and accessible to children, and report to the Chairmen of the House Appropriations and Senate Finance Committees, and to the Chairman of the Joint Commission on Health Care, by November 1, 2004." (Item 299 F)

As chair of the State Executive Council, The Honorable Jane H. Woods, Secretary of Health and Human Resources, established a widely representative task force to complete this study. This task force consisted of 32 members and was chaired by Raymond R. Ratke, chief deputy commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services. The task force held a total of seven meetings including an extended session to hear from six families who faced this impossible decision and experienced the heart wrenching and destructive consequences.

The task force initially focused on three primary areas of inquiry:

1. The extent to which custody relinquishment for the purpose of obtaining behavioral health treatment occurs and the related impacts on children, families and communities.
2. The causes, factors, policies, procedures and practices relating to custody relinquishment.
3. The existing or available best practices or model programs that offer access to services without requiring custody relinquishment (except where necessary and appropriate).

While given the extreme complexity and breadth of the issues relating to this problem, this group has not fully reached conclusion regarding these three areas. The efforts of the task force have resulted in ten primary "findings" and 18 comprehensive recommendations.

The essential and most important conclusion of the work of this task force is that this problem is a direct result of inadequate access to and availability of prevention, early intervention, and intensive mental health and substance abuse treatment services for children and adolescents.