News: Mental Health Choices

Helping kids with the most severe mental issues

Kimberly Nickoson

Andrew Shapiro (left), director of Hamilton Choices, meets with Pam Mattson and her son, Peter.

As the parent of a 5-year-old who repeatedly runs away from kindergarten and tries to commit suicide, figuring out how to keep your child safe is of paramount importance.

Having people tell you that the source of the problem is your parenting and/or poor discipline practices can be hard. Hoping you don't wind up homeless while you spend thousands of dollars on psychiatric care is even harder.

"Not ending up in a box under a bridge, that's always behind everything," says Pam Mattson, the mother of a child with multiple mental health challenges. "My husband and I are a little bit older, and though we both worked forever ... we were looking at having spent down retirement, stocks, bonds, a little bit of an inheritance from when my parents died and still we had these enormous bills piling up. It was thinking, 'Oh my God! We're going to lose our home.' During that period of time he was not well."

"He" is Peter Mattson, a 15-year-old kid who looks just like every other boy his age. But he isn't like other kids because of his suicide attempts, psychiatric hospitalizations and other problems as a result of having bipolar disorder and Asperger's syndrome, a form of autism that is typically characterized by unimpaired cognitive function but difficulty in dealing with other people and lots of stimuli.

"That combination is really skunky because the meds for one exacerbate the other," Pam says. "It was kind of tough trying to tease out what kind of diagnosis we have, what kind of help is out there, what can you afford, what works and what doesn't."

'Don't look sick'
After the lifetime psychological care benefit for Peter's medical insurance coverage was exhausted at age 9, the Mattsons were facing $1,000 a month for his medications, having to pay for anything related to a psych diagnosis and trying to find the kind of therapy and other services that would make it possible for their son to lead a normal life.

That's where Hamilton Choices ( comes in — the Hamilton County mental health program that offers intensive, hands-on assistance to match at-risk youth and their families with the support services they need.

To qualify, the children under the age of 18 must be involved with at least two county agencies — Department of Job and Family Services, Juvenile Court, Mental Health and Recovery Services Board or Board of Mental Retardation and Developmental Disabilities. Any of these agencies can refer families to Choices when the child needs more than an individual therapy or other services typically offered.

Modeled on the DAWN Project (, a Cincinnati collaboration called the Multi County Systems Agency created a pool of funds that comes from each agency's budget. Case managers are free to be as creative as they need to be to create a plan for each individual child and use the pooled funding as they see fit.

"Choices has literally saved his life," Pam says of her son. "What Choices did is they were able to offer him services that no one else was."

A big part of that service, after finding therapies and resources that can be very unconventional — such as equine therapy — is educating care providers, schools and the community, she says.

"There's a ton of stigma, and even though the awareness has been raised lately, it's always going to be a tough road for parents who have kids like this — and for the kids," Pam says. "Our kids don't look sick. He's not diabetic. But believe me: If there were a medication we could give him that would stop him from having this, we would. Are you going to say to a diabetic, 'You're not really sick, just tough it out and you won't have high sugar or low sugar'? It just doesn't make any sense."

Peter agrees.

"You can't tell a blind person to read," he says.

'Actually capable'
Understanding the child and the family is the first step, according to Rhonda Craig, director of program operations.

"They have allowed us to come brainstorm with then on what can help their family," she says. "They are the brain-trust of what goes on with their family. We're a mental health agency, so typically what we get (is) spreadsheets on kids and all the deficits. How do you look past all the deficits and look at some of the strengths — not just that the kid has, that this family has."

A typical day in the life of a family in the system can include meeting with one specialist, getting test results from another, going to meet with a caseworker — and toss in everyday life of managing a family, often with multiple children. Craig says the slightest glitch in organizing all that information can be disastrous, if you aren't already overwhelmed by the meetings.

"What makes us different is what we do. ... Care coordination — what we do is become the filter for that family, where we have meetings here where we have everyone come together," Craig says. "Pam'll tell you right now: The cookie-cutter stuff doesn't work. We wouldn't be here if it did work. We're not rocket scientists either."

Having just received a renewal of its contract to continue providing county services, Hamilton Choices is already planning on how to improve care for clients. After children achieve certain goals and are discharged from the system, Choices wants to track how well they're doing. The goal is "sustainability," making sure kids and families have what they need to be healthy and happy into the future.

After all he's been through, Peter believes that's possible.

"Even though the kids that are in here don't fit the mold of the normal kid, even though we are different, we are actually capable of success and we are able to be productive members of society," he says. ©

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