One of the hardest days Tom O’Clair and his wife ever faced was the day they gave up custody of their son, Timothy, so he could be treated for mental illness.
But they said it was not nearly as painful as the day their son took his own life.
O’Clair said he believes his 12-year-old son’s suicide could have been prevented if his family’s insurance company had covered mental-health treatment as it does treatment for physical health.
A bill bearing Timothy O’Clair’s name that would require mental-health insurance coverage on par with physical-health coverage may become a law in New York this year. The state Senate, which for years had opposed the law, passed a revised version in September. For the bill to become law, the Assembly would need to convene a special session to approve it, and Gov. George Pataki would need to sign it before the end of the year.
“We’re pretty sure the Assembly will come back in November, and we’re hopeful that (Pataki) would sign it, but we have not had official word from the governor,” said Ruth Foster, director of Public Policy for Families Together in New York State, the group that has pushed for the Timothy’s Law.
The Diocese of Rochester’s Public Policy Committee recommends support for the law as part of its focus this year on children at risk.
The point of Timothy’s law, child advocates say, is to help address a gap in insurance coverage. The poorest tier of New Yorkers has access to Medicaid, which allows for adequate mental-health insurance coverage, as long as mental-health providers who will accept Medicaid patients are available. However, the bare-bones mental-health insurance of the working poor may require steep co-payments and may cover only a few mental-health visits, advocates say.
Projections of the law’s economic cost are minimal, Foster noted.
“At most we believe it will cost $1.26 per month per year, per employee, and we’re convinced it’s not going to cost even that,” she said.
According to a 2001 U.S. Surgeon General’s report on mental health, people in the lowest strata of income, education and occupation are about two to three times more likely to have a mental illness than those in the highest strata.
Dr. James Wallace, a private-practice child and adolescent psychiatrist who also works at Unity Behavioral Health’s St. Mary’s Clinic in Rochester, said several factors might increase rates of mental illness in the urban poor.
“They tend to move a lot, and that destabilizes families,” Wallace said. “They tend to be witnesses to violence and drugs, so they tend to be traumatized.”
A lack of adequate transportation and child psychiatrists, who can prescribe medication, can make it difficult for people to get the mental-health help they need, Wallace said. Other factors that can contribute to mental illness include low birth weight, prenatal exposure to drugs and alcohol, and childhood lead exposure, he said. On the positive side, urban families may have large social-support networks and strong faith communities that can help them access the care they need, he said.
Often, mental-health benefits require a 50-percent co-payment, which could mean a co-payment of $50 to $100 every time one sees a doctor, Wallace said.
“There are lots of families that can’t do that,” Wallace said.
Timothy O’Clair’s family was one of those that couldn’t, his father said. Although Timothy started off with the energy of any typical kid, his condition and medical bills quickly became worse.
“Timothy was just a ball of fire,” Tom O’Clair said. “He was kindhearted, and very loving and compassionate.”
When he was about 8, Timothy’s teachers noticed signs of trouble, such as a violent essay he wrote. His parents spoke with his pediatrician, and they were referred to a several psychologists. Their insurance covered 20 outpatient visits and 30 inpatient days a year, although their co-payment after several visits increased to at least $35 per visit, as compared to $10 for a physical-health visit and the initial mental-health visits.
“Every year we would try to budget the visits, in the hopes that we would get a full year of them,” O’Clair said. “As the years went on, Timothy got worse.”
Eventually, his parents decided to give up custody so he could become a ward of the state and receive Medicaid coverage. His parents also had to pay $226 a week to the state for statutory child support.
“He had to listen in court to his parents say they cannot have this child in their home, that they cannot deal with his behaviors and that they can’t help him and can’t fix him,” O’Clair said. “That was a very painful thing to do. We knew we had to do it, but it didn’t make it any easier.”
The decision allowed Timothy to receive round-the-clock care in a children’s home, where he even saved the life of another boy who had tried to hang himself. In the children’s home, O’Clair said Timothy regained much of his old, cheerful demeanor. He was able to return to his parent’s home in January 2001, and O’Clair said for the first three weeks Timothy became the boy they hadn’t seen in years. The next three weeks were a rapid downward spiral, ending when Timothy’s mother found that the boy had hanged himself in his bedroom closet.
“It was tough trying to get a handle on our lives, and trying to figure out how to continue,” O’Clair said.
The family began taking part in a grief-support group. Eventually, advocates received the family’s permission to use Timothy’s name to draw attention to the bill. O’Clair is now a trained grief counselor, helping to lead a grief-support group that helped him. He’s also on the board of the state mental-health association.
Finally, he’s an advocate for the law that bears his son’s name.
“Had they passed a mental-health parity law, I’m convinced he would still be with us,” O’Clair said. “We are determined to see this through and see justice done.”