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Case spotlights needs in rural regions By LYNN BONNER STAFF WRITER Four-year-old Kyle Collier, di- agnosed as autistic and bipolar, needs therapy to help him cope with his oversensitivity to light, touch and sounds. Kyle is not toilet trained; he kicks, hits and bites when his daily routines are disrupted or when he is in a room with all fluorescent and no natural fight. He needs S summer enrollment in a center to teach him skills that will make it easier for him to continue living with his family in rural Harnett County. But Kyle's mother, Orbie Etheridge, said she has spent more than a year trying to find long-term professional help for her youngest son outside school. An agency in Fayetteville is work- ing with Kyle, but it has not been able to arrange all the specialized help he needs. I found myself completely alone and frustrated; Etheridge said. That was until a judge ordered Dec. 22 that the state must get Kyle the help he needs. "The state may not fail to pro- vide a medically necessary ser- vice to a Medicaidefigible child because it is too expensive, not listed in the state plan of services, or difficult to provide," Adminis- trative Law Judge Fred G. Mor- rison Jr. wrote. Kyle's case highlights the lack of specialized mental health ser- S vices for children in the state's rural communities. A :consultants' report in December on the state's mental health system put in writ- ingwhat has been known for years: Rural areas get the least service. The state Department of Health and Human Services may reject Morrison's order. A department spokesman said Mike Moseley, head of the state's mental health office, had not seen the order and could not comment on it if DHHS decides not to go along, Kyle's at- torneys could ask for a state Su- perior Court review. Etheridge, however, hopes Mor- risori s order not only will force the state or the local mental health office to get Kyle the help he needs; she hopes it ends up help- ing other rural children, too. "If we can make any difference at this point, it would be a won- derful change," she said. The local mental health agency, Sandhills Center, agreed that Kyle needs the therapy. It's just that what Kyle needs isn't easily avail- able. Statewide changes in mental health care, in which local gov- ernments gave up providing di- rect care in favor of private agen- cies, are the reason Kyle isn't getting what he needs, his attor- ney Lewis Pitts said. . "The so-called mental health re- form has been deformed," Pitts said.'"I'hey're not making the ser- vices available for high-need kids." Michael Watson, chief execu- tive officer at the sandhins Center, the.local mental health office that covers Harnett, did not want to discuss Kyle's case. But problems with getting highly specialized ser- vices to rural areas aren't related to the mental health changes in- stituted in 2001, he said. "The issue is: Can you put to- gether a package of services; can you create a specialized program for one person?" Watson said. "How do you deal with distance? We're into issues of distance and availability, which is very difficult" Morrison's order says Kyle should have occupational therapy . in the afternoon, so he can stay in school at least until 1 p.m. In the summer, Kyle should have day treatment at a place no more than 45 minutes from his home. A few years ago, Pitts sued the state on behalf of a teenage boy in the mountains over the lack of crisis care near his home in Fletcher, south of Asheville. Pitts; a legal aid lawyer in Durham, sees a thread running through the cases - the lack of rural mental health care for chil- dren. "We're going to keep taking them one at a time," he said. "We're trying to get someone to listen." Staff writer Lynn Bonner can be reached at 829-4821 orlbonner@newsobserveccom.