The juvenile program in Augusta's community mental health facility that provided low- and no-cost mental health services to more than 900 children is being downsized to treat only the most severe cases.
Officials at Child and Adolescent Services at Serenity Behavioral Health Systems are referring hundreds of patients to private mental health professionals.
With few licensed psychiatrists and fewer mental health professionals who accept Medicaid, those who depended on its services are feeling the cut.
"We are doing our very best to hook up (patients) with another provider, but the challenge is the appointments are so far in the future it's very difficult to make those linkages," Serenity CEO Charles Williamson said.
Serenity will continue treating children with severe mental illness but will no longer be available to most of the public. In the past, the facility would have seen one child for every adult client, but it will now be reduced to one child for every six adults, Williamson said.
Child and Adolescent Services lost its funding from the state in 2008 but continued functioning for two years until October, when the burden became too heavy, Williamson said.
"We waited as long as we could, and it started to hurt us so bad financially we said, 'OK, let's focus on what we're getting paid for, which is the adult population,' " Williamson said.
The Department of Behavioral Health and Developmental Disabilities provided Serenity with $1.2 million of funding in 2006. That support decreased to $569,000 in 2007 and was eliminated in 2008.
Children in families who were underinsured or uninsured used Serenity's services of family and individual counseling and inpatient care.
It was often a resource for judges sentencing children with mental health issues in Juvenile Court and an alternative to incarceration in the Augusta Youth Development Campus, said Juvenile Court Judge Jennifer McKinzie.
During the Nov. 10 status hearing of a juvenile who attacked a pregnant Collins Elementary School teacher this year and caused her to lose her baby, McKinzie said she was devastated that Serenity's services were no longer a resource for him.
The child's parents begged for inpatient treatment but were without options after Serenity's downsizing.
Laura Miller, a dental hygienist in Augusta, said that without Serenity she has to drive three hours to Inner Harbor in Douglasville, Ga., to get inpatient treatment for her 12-year-old daughter.
After her daughter was diagnosed with bipolar disorder during the summer, she received a week of inpatient care at Serenity.
Later, when the girl's behavior got worse and she needed long-term care, the safe haven of Serenity disappeared and she was checked into YDC for one month.
"There's just not enough help for children in the area," Miller said. "A lot of the kids in YDC, they're not bad children. They need mental help."
When she returned home, her daughter became violent against Miller and the family's cats and showed behavioral problems that Miller couldn't control.
Miller took on a third job to afford treatment at Augusta's Transitional Family Services because her ex-husband's insurance would not cover their daughter's mental health services.
When her daughter became covered by Medicaid, the inpatient center in Douglasville was the family's only option.
"It's a sad situation," Miller said. "I just really hate it that this is happening where they have closed (Serenity) because there's so many children that need this in the area. It's so sad."
Dr. L. "Mike" Daniels, an Augusta psychologist, said private mental health facilities were already overwhelmed with clients before Serenity's downsizing.
In addition to his private practice, he joined Stillwater Counseling this month to help with their overflow of patients, which he said he is sure will now worsen.
"They are absolutely overwhelmed," Daniels said of Stillwater. "We have more kids than we know what to do with, and there's nobody else to see them."
For some children, sitting on a waiting list to see a professional is not an option.
Many families who used Serenity's services can't afford the alternative of private practices, Daniels said.
Those restrictions can partially be blamed on the care management organizations the state contracted in 2006, which manage Medicaid and authorize treatments, said Serenity's clinical director, Michelle Carnes.
"I guess these care management organizations are trying to save the state money," Carnes said. "They've made that process very difficult, and they don't always approve of the services the child may need."
Richmond County Juvenile Court Judge Ben Allen said children who don't have access to mental health services often act out. He sees them bypass treatment and end up incarcerated instead.
"We've got to find a better way to serve our youth population," Allen said. "(Incarceration) is not the proper way to treat mental illness. I'm hoping I don't have to make that kind of choice."
Daniels said he sees the effects of state budget reductions for mental health services too often in his office.
"Fewer and fewer resources are given to the treatment of the mentally ill, both children and adults," he said. "The money is just drying up. Unless we have a change in governmental thought process, we're going to have to start looking ... at charitable giving.
"These are our new mental health treatment facilities: the jails and juvenile detention centers."