When Suzanne Ellis was awakened by the phone at 2 a.m. on July 7, she knew her son Tommy was in trouble. The voice at the other end of the line was her ex-husband, who had taken Tommy into his home two months earlier. "I can't keep him here," she remembers the boy's father saying. "I can't put up with this."

Her ex-husband had just picked up the fourteen-year-old Tommy at a juvenile holding facility in Phoenix, where he had been taken after being arrested at a hotel at Union Hills Drive and the Black Canyon Freeway. Tommy had stolen his father's truck and wrecked it, trashed his father's house and taken anything of value, including weapons.

Hotel guests, Ellis says, called the police after seeing Tommy toting his arsenal--5 handguns and 500 rounds of ammunition--through the parking lot.

"He was in la-la land," Ellis explains.
Tommy had been hospitalized once before for schizophrenia and obsessive-compulsive disorder. Her son is mentally ill and needs to be hospitalized once more, his mother insists, but she has no way to pay for treatment this time. Ellis is a beautician and her insurance has run out. Her ex-husband wants nothing to do with Tommy. In the two months he lived with his father, in fact, Tommy was allowed to abandon his lithium treatment and psychiatric visits.

So with no money, Ellis turned to the state to solve her problem. But she found that there was no money left to place Tommy or others like him into in-hospital, residential treatment. The money is committed to other juveniles already receiving residential treatment.

"The number of kids that need that treatment today exceeds that amount of money we have for the whole year," says Dr. Glenn Lippman, medical director of the Department of Health Service's Division of Behavioral Health. The problem, state officials say, is a literal explosion in the number of juveniles needing residential care. Hundreds of juveniles could be awaiting treatment, says Maria Hoffman, founder of the Arizona Center for Counseling Children and Adolescents. Despite large funding increases, state officials say they can't keep up. In two years, the children's residential care budget has jumped from less than $856,000 to $4.9 million, but the number of children being treated has increased fivefold, from 24 in residential treatment two years ago to 126 today.

"We have to make a choice," says John Morrison, Phoenix-based Community Care Network chief. "We either take in fewer kids or we provide alternatives." His organization is one of eight newly created "entities" in Arizona, including three in Maricopa County, that are contracting mental health treatment for the state Department of Health Services.

In some ways, the children's mental health program is a victim of its own success. Publicity about the increased state mental health funding has caused a flood of applications for the new services. "Everyone hears this and says, `My God, now we can get treatment,'" Morrison says. "If we had to spend our dollars for every parent who wanted their child in [psychiatric] residential care, we'd have to spend $150 million per year. That's impossible." Because of this crisis, state officials and the mental health contractors are scrambling to come up with alternatives. The state is trying to pay for indigent juveniles such as Tommy by using federal matching funds, and steering the youths to less costly treatment like intensive out-patient therapy and group home facilities.

But state officials concede that even this may not be enough. Governor Rose Mofford's recent announcement of a $108 million budget shortfall is sending chills down the spines of private agencies that have been promised funding but do not yet have written contracts with the state. Mofford has ordered department heads to slash their budgets between 3 and 7 percent.

Although Lippman says, "The money will flow," he admits he doesn't know when or how much. "Right now, we're trying to deal with the more critical of the critical areas before we take the less critical of the critical areas," he says.

Alan Flory, president of CODAMA, says his group is still awaiting action on a contract that would provide alternatives to residential care. His agency would "implode," he says, if that contract is not signed by DHS. CODAMA is one of three "entities" in Maricopa County that receives state funds to contract treatment with private mental health agencies. But in the meantime, children like Tommy can't get the help they need.

When Tommy came home from the police station, Ellis took him to the Emergency Psychiatric Unit at the Maricopa County Medical Center.

Tommy, she says, had told psychiatrists he planned to "chop up" her ex-husband's new wife. He had once chased his sister with a butcher knife.

"I was scared out of my wits," Ellis says. "I knew if I took him back it would happen again. Only this time there will be victims. I'm afraid for my life. I'm afraid for his, and I'm afraid for the lives of others." When the state's Child Protective Services called to demand Ellis take her son home because he was "stabilized," she closed down her beauty shop, left town and hid out for two weeks. In those two weeks, she tried to get him into residential care, but was told that her son could not be placed in the program.

Instead of accepting her son back, Ellis filed suit to make him a ward of the state. In what she calls a "desperate act," his mother abandoned Tommy so that he could get help.

On November 27, after a court order and after spending three months in the emergency psychiatric unit of the Maricopa County Medical Center, Tommy was placed into Arizona Youth Association, a group home for emotionally and mentally disturbed juveniles.

"I gave up custody of my child to force the state to meet his needs," Ellis says.

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J. W. Casserly