Wings of protection > Program helps mentally ill kids remain at home

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Two summers ago, Roberta Allen, which is not her real last name, took part in a quiet, nightly ritual that outlined better than any psychological text the tragic disintegration of her family. Before she could sleep, she would grab a flashlight and walk down the country lane in front of her home near Deer Isle, checking the pastoral fields of her midcoast town for her troubled, homeless teen-age son.

She usually found him asleep under the stars.

Only after her flashlight swept over his prostrate form, only after she could see that he was still breathing, could the mother return home for a few hours of sleep.

The stress of dealing with an out-of-control teen-ager was taking its toll on everyone in the Allen family. Roberta Allen, a homemaker and caretaker for some coastal families, could no longer work. Her husband, a full-time groundsman and caretaker, had been deprived of a good night’s sleep for more than a year and was talking suicide.

The Allen family needed help, and they needed it quickly.

Enter Wings for Children and Families Inc., a program with headquarters in Bangor that offers the kind of help the Allens so desperately needed.

Called the “best-kept secret in town” by its executive director, Kathy Bubar, the federally funded program enfolded the Allens in “wraparound” care.

“Wraparound” is a unique, personalized approach to helping mentally ill children and their families, with a goal of keeping children in their homes and communities, rather than hospitalizing them for long periods of time.

It has worked for about 250 children served by Wings, according to Bubar, and it also worked for the Allens, who eventually were reunited as a family.

A serious situation

When Wings case manager Patricia Niedorowski was assigned the Allen case, she found a family in a “pretty serious, severe situation.”

Fifteen-year-old Brian, also not his real name, had been kicked out of the house in the summer of 1995. A drug addict and alcoholic, the youth apparently had his addictions under control, but he was rebellious at home and alternately bored and destructive at school. Local police were beginning to notice him because of a few unexplained thefts in the area and because of a few shady acquaintances Brian had kept from his days of dealing drugs.

Adding to the youth’s problems were months of heated arguments and tension with his parents. “We’d fight, he’d leave, then we’d worry all night about where he was,” Roberta Allen recalled.

Finally, Brian broke a few house rules too many, forcing the Allens to do something to regain control, his mother said.

“He called up one night to say he’d be home late, and I told him he couldn’t come home at all. He didn’t believe me at first, but I was angry. It was the hardest thing I’ve ever done in my life,” Allen said.

Anytime a child has left home it signals a family on the edge of breaking up. In the Allens’ case, “they already were blown apart,” said Niedorowski.

Complicating the Allens’ situation were the depression and instability of the parents who, exhausted after dealing with their son, were being forced to make radical decisions affecting their family.

They had sought help from schools and other agencies, but “the system wasn’t responding,” Niedorowski said.

After evaluating the family, Niedorowski dispatched behavioral experts to the Allen home for several hours a day to get the family back on track. She arranged school meetings to chart the best educational course for Brian, who had been politely “disenrolled” from three high schools because of truancy. She arranged counseling sessions and weekend respite care for the boy at a Bangor foster home while his parents recuperated from years of stress.

Two years after their crisis, the Allens are living under the same roof. Brian, who was diagnosed with attention deficit hyperactivity disorder, ADHD, oppositional defiant disorder and substance-abuse problems, is working toward his general equivalency high school diploma, or GED, with the help of tutors. He has been sober for 2 1/2 years. The family has learned to resolve issues without the threat of violent fights or someone leaving home.

“I’ve got my son back,” Allen said recently. “I tell him, `I loved you always, but now I like you.”‘

The tragedy of mental illness in children

About one in 10 children nationwide — an astounding 6 million young people — have serious emotional and mental disburbances, according to the national Health and Human Services Administration. About 10,000 Maine youths are plagued with serious mental illnesses, according to the Children’s Services Department within the state Department of Mental Health, Mental Retardation and Substance Abuse Services.

Maine has the second-highest hospitalization rate in the nation for its mentally disturbed children, according to Mental Health Commissioner Melody Peet. Mentally unstable kids often are shipped to hospital wards or foster homes because services that could keep them home are not available.

A program like Wings most likely could bring most of these young patients home, according to Bubar and federal bureaucrats in Washington, D.C.

Wings clients now include:

Jason, 10, from Somerset County, who is recovering from trauma and bipolar illness, and his 8-year-old sister, recovering from trauma and suicidal depression. Most of the siblings’ problems were precipitated by severe, ritualistic abuse at the hands of their father.

Frankie, 7, of Penobscot County, who first was hospitalized at age 4 after threatening his mother with a knife and stabbing his sister in the leg with a screwdriver. He also attemped oral sex with other children. Diagnosed with major depression, ADHD and a host of other ailments, Frankie, through Wings intervention, has improved markedly in the last few months. He will enter second grade in the fall and recently was taken off the list of pupils needing special education services.

Sean, 16, of Penobscot County, who has recovered from severe psychological problems which began eight years ago when he started refusing to attend school. His anxiety appeared after he suffered severe injuries in a car accident and escalated as he entered adolescence. An evaluation showed he had school phobia, anxiety and depression. Hospitalized with suicidal tendencies at one point, Sean now is an honor roll student at an alternative high school. He spends time with friends who have replaced Wings one-on-one workers, and recently received his driver’s license.

Two-thirds of the 250 children served by Wings are male, and the average age of clients is 12, although Wings has seen children as young as 3.

Attention and praise

Wings is a private, nonprofit corporation formed in 1994. Its 14-member board of directors is headed by Lt. Don Winslow of the Bangor Police Department. Bylaws of the corporation dictate that 55 percent of the board be composed of parents of Wings children, and 57 percent of the present board are parents, Bubar said.

Federal dollars for Wings, totaling close to $17 million for five years ending in 1999, come from the Substance Abuse and Mental Helath Services Administration, a division of the Health and Human Services office in Washington, D.C. The state of Maine, on paper, has committed close to $12 million to Wings over a five-year period that started in 1994.

Wings’ ability to offer effective treatment at costs significantly less than residential placement has been pitched to state officials. They clearly have heard the message.

“It is a different way of doing business,” said Robin Boustead, children’s program manager for the state Department of Mental Health, Mental Retardation and Substance Abuse Services.

“We have had a mind-set that you go away to residential treatment and get cured and come back, but in mental health, especially dealing with children, that method has been found to be ineffective,” Boustead said.

Boustead and others are developing a “legislative initiative” to develop a children’s mental health system statewide based on Wings’ example. Of particular interest is using a Wings-type program to bring several dozen severely disturbed Maine children back home who now are hospitalized in states as far away as Texas.

Statistics from the Department of Mental Health, Mental Retardation and Substance Abuse Services reveal it costs about $1,500 a month to keep a high-needs child in the home and community, compared to $1,000 a day to keep the child in a hospital. Costs for out-of-state hospital placements range upward to $315,000 a year.

Wings’ most expensive client, a 13-year-old girl who has had to be hospitalized repeatedly, will cost the program about $100,000 this year, a third of the cost of keeping her in an out-of-state placement once considered for her.

Funding questions and high marks

One of 22 similar programs funded nationally, Wings for Children and Families Inc. will lose its federal funding, $3 million a year on average, in about 18 months. The plan by the national Substance Abuse and Mental Health Services Administration was to fund the sites for five years, then gradually replace federal money with state dollars.

That hasn’t quite occurred in Maine. Although state money has been formally identified for the Wings program, none has been forwarded to Wings headquarters. The reasons state matching funds are technically available but not forthcoming are complex and relate to technical definitions and accounting practices.

The federal government apparently has accepted the state’s word that it will kick in money for Wings, but the financial future of the program remains uncertain, leaving clients and program staff wondering about its fate.

Despite financial questions surrounding its future, Wings for Children and Families Inc. has won approval from the feds for its performance to date.

“Wings has done a good job of bringing families into the process and getting them engaged with services for their children,” said Michael English, director of the Division of Knowledge Development and System Change in the Substance Abuse and Mental Health Services Administration. English said a program serving 45 children on the Passamaquoddy reservation in Indian Township is “culturally competent and especially noteworthy.”

Nationwide, programs like Wings have been so successful that the federal government plans to add nine more sites in the next year, said Tom Bornemann, deputy director of the Substance Abuse and Mental Health Services Administration.

Federal officials will come to Bangor Aug. 18 and 19 to review the Maine Wings program.

They made it clear the state may regret it if it doesn’t pick up funding for Wings.

“We don’t want to see the program fold. We don’t think the people of Maine will want it to fold once they realize the value and cost-effectiveness of treatment offered through Wings,” said Bornemann.

People who want to lobby for the program are being urged to contact Mental Health Commissioner Peet or staff in the Department of Mental Health, Mental Retardation and Substance Abuse Services.

An evaluation of the Wings program recently completed at the Margaret Chase Smith Center for Public Policy, University of Maine, concluded that the wraparound process is making a difference in the lives of families supported by Wings and is doing it at a significantly lower cost than keeping children in hospitals or institutions.

It cost $11,751 for 20 months of intensive care for Brian and his family in Hancock County.

Today, the Allens no longer use Wings, although Roberta calls the case manager for occasional advice and support.

A personable youth, Brian succinctly summarized the value of Wings for Children and Families Inc.

“It gave me a family,” he said.

Further information on the Wings program may be obtained by calling 941-2988.