All of us were horrified over the senseless massacre that occurred last week at the Sandy Hook Elementary School in Connecticut. Twenty children and six adults, including the perpetrator's mother, were unconscionably shot multiple times and killed. As we all mourn as a nation, we also ask why and begin, for the hundredth time, asking how to prevent such heinous acts from occurring ever again.

Just as we found ourselves doing in July after the Aurora theatre shootings, we are embroiled in considerable debate about gun control. While there must be a way to ensure the constitutional right to bear arms while simultaneously protecting innocent victims, I want to address another issue that requires our attention as well.

Improving mental health services

While there are the beginnings of a dialogue about improved mental health services, it has not nearly been at the same pitch as the gun control debate. Ironically, all of the recent shootings in churches, theatres, malls and now an elementary school have been perpetrated by young people who suffer from serious behavioral and/or mental health issues and who have had access to assault weapons.

Almost daily children arrive in our Emergency Department in need of mental health services. Our inpatient unit stays so busy we often find ourselves accommodating them in a seclusion area of the Emergency Department until an inpatient bed frees up. Other inpatient beds for young children across the state including the State of Colorado's inpatient child units at Fort Logan have been closed or provide limited services.

Barriers to access

The availability of community outpatient resources is even scarcer. How many tragedies could we avert if the appropriate preventative and therapeutic mental health services were available to our children and their families?

While parity laws may require insurance plans to provide coverage for mental health services, the reimbursement remains a fraction of the actual cost. Those providers who do treat these children do so at their own financial peril. Many providers including the State simply cannot afford to continue providing services.

Our obligation

As individuals, parents, health care providers and leaders we have an obligation to offer solutions. Children's Hospital Colorado is participating in a Coalition of Children's Hospitals proposing a national transformation in the care and payment for chronically ill children, INCLUDING those with mental health conditions.

We can change the delivery model such that prevention and acute treatment can be available to children who are in need of mental health services. The key to transforming these services for children will be to align evidence-based practice with the actuarially-appropriate financing mechanisms. Some will argue that there just is not enough money to cover these services. I would argue we can no longer afford not to.

I welcome your thoughts. Email me at dearjim@childrenscolorado.org.