I recently attended a panel discussion about the challenges providing mental and behavioral health services to kids and families in Massachusetts. Over the course of the 2 plus hour discussion, I was profoundly frustrated by the repeated use of the phrase, "Failing Up".
"Failing Up", is a phrase that describes giving a child the least amount of support necessary, in an attempt to make them successful in their school or treatment environment. This system is a veiled attempt to frame what is naked cost control as something that has some benefit to our kids. It is a regular occurrence to hear educators invoke the importance of "least restrictive environment" and within that paradigm they include the least intensity of services. Only when a child fails to make progress, or tanks completely, will there be a rapid response to decide the best and next, more intense course of action. Unfortunately, the next, more intense intervention, may still not be everything that could be done and the painful process often drags on endlessly in a cycle of under supported children in a downward spiral. The solution, giving everything available as early and intensely as possible, is never proposed as an option. The reason is budgets and cost control fly in the face of what science says is needed, early and intensive intervention for optimal outcome. A good example is the treatment of autism spectrum disorders; "individuals generally receive earlier, more intense interventions, and more ABA, whereas HFA individuals receive more pharmacologic treatments" Deborah Fein et al.
So is it really saving money to push these kids with debilitating mental illnesses and under supported disabilities along? Won't those kids, who may have landed on better, healthier trajectories with very intense services at the first sign of distress, remain a drain on resources, when they continue to need re-evaluation and adjustments to service levels just to stay in school? What is the cost to society when their issues outlive their school careers and they arrive at adulthood's door unable to cope with daily life?
"Failing up" is a symptom of how bureaucracy and unfunded mandates are failing our kids in their schools and mental health facilities. The question is what can we, as a society, do about it?
