- Associated Press - Sunday, June 14, 2015

BOISE, Idaho (AP) - A decades-long legal battle over the state of child mental health services in Idaho has ended in a settlement that will require a major overhaul of the system.

It started in 1979 in Blackfoot at State Hospital South, a mental institution where 17 children with mental disorders were housed. Child molesters were housed there, too. There was no school, but there were mind-numbing drugs and beds with restraints.

One of the children housed there at the time was a 17-year-old named Jeff D. - a name that since has become synonymous with mental health reform in Idaho.

Jeff’s mother had abandoned him, and at age 2 he had watched his foster parents beat his sister to death while they were on a berry-picking trip in western Washington, the Spokesman-Review reported. Psychiatrists later said they suspected the experience had irreparably scarred him.

When Howard Belodoff and Charlie Johnson, two attorneys barely out of law school, discovered the conditions in which Jeff and the other children were living, they filed a class-action lawsuit against the state. That was 1980.

During the next 35 years, the suit was repeatedly settled and reopened as Belodoff accused the state of failing to live up to its end of the bargain. Each time he won, and a new settlement was drafted.

Through four decades it was courtroom fisticuffs, but today, both sides have struck a different tone. Both sides made a decision that collaborating on solutions would work better than endless legal brawls.

Belodoff said this is the most optimistic he has felt during his time on the case.

“I am very encouraged by the fact that the governor himself has indicated that he recognizes and supports the agreement,” Belodoff said. “That’s never happened in all the years (the case has been active).”

Ross Edmunds, behavioral health administrator with the Idaho Department of Health and Welfare, agreed.

“It feels like for the first time the resolution between the plaintiffs and the state has come to a collaborative process,” he said.

Previously, the state’s main concern was trying to stay out of the courtroom, Edmunds said. But sitting down with child advocates and collaborating to find solutions “changed the game.”

The settlement calls for four major changes:

- Increased mental health screenings in all state agencies and institutions that serve children.

- Creating a system of community-based mental health services.

- Engaging children’s families in their care.

- Monitoring service quality and outcomes.

And the state will strive to integrate those services.

“Idaho’s system has a fair amount of fracture in it right now,” Edmunds said.

But the new system will allow schools, social workers and children’s mental health providers to work together to provide care.

The “backbone of the system” primarily will be provided through Medicaid, and treatment mostly will be provided by private mental health practitioners, Edmunds said.

Idaho has nine months to design the new system, and then four years to enact it. Edmunds said some service improvements will be available earlier than that. He also said the state will realize a number of benefits.

Children who wind up in juvenile detention centers at a young age are more likely to wind up in prison, if they don’t get the kind of treatment they need, Edmunds said. And children with serious mental health disorders have trouble succeeding in schools, and later in the workplace, if they aren’t given skills to cope.

Patrick Gardner, of the Young Minds Advocacy Project, which helped to craft the settlement agreement, said community-based services work much better than institutionalization.

“The focus is to deliver services to kids in the most home-like setting possible,” he said. “So rather than making kids go to clinics or emergency rooms, the idea is to put the services in the places that are most convenient and most life-like. Because that’s where the children have to learn to cope and manage their challenges.”

Belodoff said he is optimistic that the latest settlement will resolve the issues that long have kept the lawsuit open. But there have been settlements before, ones that didn’t fix the system. Belodoff brought the suit back to life each time he judged progress wasn’t sufficient.

Gardner said he never has seen anything like it.

“His perseverance is nothing like I have seen anywhere in the country,” he said. “Because of his perseverance, we have an agreement that the state favors and supports and will actually complete.”

But Belodoff, while optimistic, remains vigilant.

“The first promises were made in 1983,” Belodoff said. “To fulfill those promises and the promises of all the agreements - to provide necessary and crucial services to children and families who suffer from mental illness in the state of Idaho - I hope we have their commitment that they will carry through.”

Belodoff’s 35-year watch over the fate of mentally ill children in Idaho will go on.

“I’m hopeful,” he said. “We’ll see.”

As for Jeff D., Belodoff said he’s not sure whether Jeff knows about the settlement, or how much his case will change the state’s child mental health system. Belodoff doesn’t know where he is.

Jeff spent years on the streets after leaving the mental hospital, drifting from Spokane to Salt Lake City, toothless, sometimes forced to eat from dumpsters, the Spokesman Review reported when they tracked him down in 2002.

He could be in Boise or maybe Spokane, Belodoff said. He might be dead.

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This story has been corrected to show the spelling of the author is Bryan Clark, not Brian Clark.

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Information from: Post Register, https://www.postregister.com

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