Columns » Max Brantley

Let the sun shine in


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Mary Jacoby, a Little Rock native and former Wall Street Journal reporter, and the Times' Leslie Newell Peacock combined efforts for a cover story last week on the state's mental health care for children under Gov. Mike Beebe's administration.

Change — and it has only been in small steps so far — was sorely needed because of what this story turned up: a decade of unholy alliance between Gov. Mike Huckabee and religiously compatible operators of mental health facilities for children.

The most influential player was Ted Suhl, secretive operator of the Lord's Ranch, a residential facility for children in the hills of northern Arkansas. No story about mental health care in Arkansas is complete without a look at his huge enterprise and its long-running engagement with regulators over questions about religious influence, physical treatment of children and adequacy of its state reports. The Lord's Ranch, which speaks only through an expensive and lawsuit-threatening Washington lawyer, says it has done no wrong.  Jacoby and investigating legislators have, over the years, found patients, family and former employees who believe otherwise.

Arkansas's disproportionate spending, thanks to its over-reliance on residential mental health care, is inarguable. This poor, small state has the second highest Medicaid spending in the country on mental health for kids, according to data Jacoby compiled. The spending has grown under the Beebe administration, from $211 million in 2005 to $392 million in fiscal 2008. (Suhl covers his bets, with organizations providing both residential and community-based care.)

The issue remains under study by a Beebe-appointed commission. But 20 months into the Beebe administration, we await answers to questions about efficiency and therapeutic effectiveness of the money we spend, much less major structural changes.

During the Huckabee era, regulation of residential treatment facilities was put in the hands of the Child Welfare Review Board, consisting of executives from facilities the board regulates. This board, a legalized conflict of interest, was packed with operators from religious organizations, some of which tout their Bible-based approach. The feds frown on proselytizing with taxpayer money. Beebe at least has changed the makeup of the board. Suhl is gone. But some of those who participated in the board's foray into controversial social issue politics — with a rule to ban adoption by same-sex couples — remain. And Beebe has shown no inclination to pick up Sen. Sue Madison's failed effort in 2007 to replace conflicted board members with independent public members. Madison was clearly onto something. An e-mail from Arkansas Baptist Children's Home executive Charles Flynn to others at the time said, “Her questions indicate that she is beginning to understand more about how this system operates.”

Close study and reform are needed, with no provider, including the secular national chain giants that operate here, held sacred. This is easier to say than do. Dozens of legislators received tens of thousands in campaign contributions from people who make millions from a system they themselves control. Many prefer that troublesome kids be out of sight and out of mind. Many even approve of physical recourse to subdue the unruly. The public might not be so sanguine if they knew more about the daily lives of the children shut away for months in these homes. It's a window that Suhl and others have kept tightly shuttered when people like Jacoby came looking. We try to throw it open when we can.


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