This was an article about Cutchins intended for the Globe, but the timing didn’t work out.
5.APR.2025
BOSTON – Governor Healey’s FY26 budget, line items 5042-5000 & 5095-0015 abandons children facing mental health challenges, leaving their families with few options.
Evan was only 20 months old when Megan and her husband adopted him from the Massachusetts Department of Children and Families (DCF), spellbound by his bright blue eyes and infectious smile. Their names have been changed to protect their privacy.
Evan was about six when Megan began noticing changes. Evan became easily frustrated at times, and he might lash out. Megan worked with school counselors, attended outpatient therapy sessions, and tried in-home therapy. Megan did everything she could to help Evan. Nothing worked. Evan’s rage and outbursts only increased until an incident required medical attention. Megan had to find help when all of her options seemed exhausted.
For parents of children who face mental health challenges, the line between safety and danger can be thin. Unfortunately, this experience is not uncommon. According to the Massachusetts Department of Mental Health (DMH), these issues can arise suddenly or gradually, often catching parents by surprise and quickly overwhelming them. Parents face difficult decisions when these issues escalate to the point of danger.
Intervention often begins with a 911 call, a decision fraught with difficulty for many parents. Children are often then admitted to hospital Emergency Departments (ED) as a safer place to control outbursts. These kids may stay at the hospital for days or weeks, a practice known as Emergency Department Boarding, where psychiatric patients board at a hospital ED for extended periods. While it is said this is because there are no available psychiatric beds elsewhere, the truth is more complicated.
Emergency Departments are poorly equipped to handle child mental health issues. Children wait days just for an assessment, which only exacerbates the situation. Care for other patients suffers, too, as staff strains to meet specialized challenges for which they may have never been trained.
David Matteodo is the Executive Director of the Massachusetts Association of Behavioral Health Systems, and he knows the referral process itself can be yet another obstacle. “We have to submit a lot of paperwork, and the problem is that they make the admission kind of difficult because you have to be in a hospital for 14 days before they accept a kid.”
According to the Children’s Mental Health Campaign, Massachusetts acute care hospitals reported 173 pediatric patients boarding in EDs awaiting evaluation as of October 2021. The average ED stay for children needing high-level psychiatric care was 9.1 days before interventions reduced it to 4.3 days
While there has been some progress in reducing the total number of days children spend in Emergency Departments, it does not make the inpatient referral process any easier for parents, because their children sometimes fall below the threshold of criteria required, even when there have been repeated crisis incidents. “That is problematic if the kid has been admitted before, because they have to be in an inpatient unit for another 14 days.” Currently, this is the timeframe required when a child is hospitalized, before an inpatient psychiatric unit is able to make a referral to a CIRT or IRTP program. This 14 day waiting period is required each time a youth is hospitalized, no matter how many inpatient admissions a youth has had.
Long-term care options outside the hospital are also limited. The Massachusetts Health and Hospital Association (MHA) reports that 20% of the total psychiatric beds are offline due to staffing shortages. It is not clear what portion reflects the number of psychiatric beds for children in the Commonwealth.
Fortunately, Evan was admitted to Franciscan Hospital for his first inpatient experience. Franciscan Children’s Hospital in Boston offers short-term behavioral treatment and rehabilitation services. Evan received intensive evaluation and treatment and was diagnosed with Reactive Attachment Disorder (RAD), which affects people’s ability to form emotional connections with other people.
Megan worked hard to find a place where Evan could receive the specialized long-term care recommended by DMH and Franciscan Hospital. She exhausted every option before being referred to Three Rivers, a clinically intensive residential program (CIRT), by Cutchins Programs for Children and Families. Three Rivers is the only program equipped to handle Evan’s complex needs at his young age.
“We found angels on Earth at Three Rivers,” Megan recalls. “They choose to work with such challenging children while supporting families through this living nightmare.”
Cutchins Programs for Children and Families CEO Tina Champagne describes the Three Rivers program as, “the highest level of residential care in the state for children ages 6-12, and the only one of its kind. We work with youth and families from all across the state.”
The Three Rivers program recently migrated to a new location in Belchertown. Treatment is delivered through multi-disciplinary therapeutic modalities that emphasize building foundational skills crucial for developing healthy relationships. The program focuses on fostering safety, belonging, self-regulation, skill development and mutual respect. While a child resides at the facility, comprehensive support is provided to help both the child and their family develop the skills needed to nurture positive relationships, effectively manage stress and challenging emotions, participate in daily routines and school, and recognize and build upon their own strengths and values.
Three Rivers welcomed Megan and her family with open arms, inviting them to visit 5-7 times a week. They participated in weekly family therapy sessions and were encouraged to observe and learn from staff. This hands-on approach that begins in the program but transitions to the home, helped the family understand Evan’s struggles and develop the skills necessary to support him at home.
Three Rivers is a lifeline for families in crisis. This is a place that understands the trials of severe childhood mental health challenges. Three Rivers addresses a child’s emotional, psychological, and social needs while supporting the entire family.
The Healey administration’s proposed reduction in budget line item 5042-5000 will close the Three Rivers program. Families like Megan’s will have no place to turn for youth between the ages of 6-12. More children in crisis will have few alternatives but to seek help from crisis services, emergency responders, and hospital Emergency Departments, creating increases in ED boarding and further straining emergency services.
When asked about the repercussions of closing programs like Three Rivers, David Matteodo responded, “I don’t know where we are going to put all these kids if DMH closes those beds. If they can’t discharge those kids, it’s going to lead to a backup, which will lead to more kids boarding in emergency departments.”
According to Tina Champagne, the CIRT is sufficiently staffed to take admissions up to its full capacity of 12 beds, and it has been for the past year. The GOvernor’s rationale for the cut is a history of underutilization due to short staffing since COVID and the programs move from its former location to Belchertown.
Champagne asserts, “we have been working on identifying the reasons for the decrease in utilization since we are staffed and able to admit up to our full capacity. We are committed to working with the inpatient hospitals and DMH to identify ways to expedite the referral process and make sure hospitals know that the CIRT and IRTP services exist. Currently, these are the primary reasons that have negatively impacted utilization”. Champagne further reports, “since we have identified and started to address these issues our referrals have increased rapidly over the past two months.” Decreased utilization does not equate to no need. If the CIRT program is cut, the youth with the most severe emotional and behavioral needs in the state will have no program like this to turn to in Massachusetts.
One of the program’s parents did not know about the CIRT and thought she was going to have to send her youth to a similar program based in California. Once she became aware of the CIRT, and advocated for her child to be referred, she found that the CIRT program was available and located just an hour from her home.
It is imperative to reinstate the CIRT program and the program’s funding for budget line items 5042-5000 & 5095-0015 to ensure children have access to the mental health services they need and deserve in the Commonwealth.
Christopher J. Sparks is a member of the Cutchins board.
References
- Children’s Mental Health Campaign. (n.d.). Pediatric Emergency Department Boarding. Retrieved from https://www.childrensmentalhealthcampaign.org/pediatric-emergency-department-boarding/
- Boston Children’s Hospital. (2024, April). Easing mental health boarding in the emergency room. Retrieved from https://answers.childrenshospital.org/mental-health-boarding-emergency-room/
- Massachusetts Health & Hospital Association. (n.d.). MHA’s Behavioral Health Reports. Retrieved from https://www.mhalink.org/bhreports/
- Children’s League of Massachusetts. (2025, February). CLM’s FY26 House Budget Advocacy for Children & Families. Retrieved from https://www.childrensleague.org/clms-fy26-house-budget-advocacy/
- Massachusetts Association for Mental Health. (2025, January). The FY2025 Massachusetts State Budget: Implications for Behavioral Health. Retrieved from https://mamh-web.files.svdcdn.com/production/files/The-FY2025-Massachusetts-State-Budget-Brief_FINAL.pdf
- Massachusetts Department of Mental Health. (2025, February 20). Annual Expedited Psychiatric Inpatient Admission (EPIA) Advisory Council 2023 Report. Retrieved from https://malegislature.gov/Bills/194/SD2680
