Journal Issue: Domestic Violence and Children Volume 9 Number 3 Winter 1999
Betsy McAlister Groves
Funding Mental Health Services
One source of funding for mental health services is health insurance. The U.S. Census Bureau estimates that 11.3 million children in this country are uninsured.32 Uninsured children may have a difficult time accessing mental health care. Even when a family has private or public health insurance, mental health coverage is likely to be inadequate. Families may be forced to choose from a fixed list of providers, without regard for the provider's experience or expertise with domestic violence or trauma. Services usually are capped at a certain number of sessions, often a number that is inadequate for the complexities that domestic violence presents. Insurance policies may not cover services such as a therapist's consultation with the child's school or contacts with pediatricians, attorneys, or other providers involved with the family. Finally, insurers typically will not cover services provided in the absence of a diagnosable mental health disorder. Thus, children who are suffering, but whose symptoms do not fit into a defined diagnostic category, may not be eligible for reimbursement.
Public and private grants to particular agencies constitute another source of funding for mental health services provided to children who witness domestic violence. In recent years, there has been increasing federal awareness about the needs of families affected by domestic violence, leading to passage and funding of the Victims of Crime Act and the Violence Against Women Act. Some states, such as Massachusetts, have also invested substantially in services to this population. The disadvantage of grant funding is that it is not a secure source. Programs must operate with continual uncertainty about the availability of ongoing funding, and thus may be compromised in long-term planning. (For more information about federal policies regarding domestic violence, see the article by Matthews in this journal issue.)