Sherri Cook gets a kiss from her son, Chance Roth.

“Columbus said the world is round?
Don’t you believe a word of that.
For I’ve been down to the edge of the world,
Sat on the edge where the wild wind whirled,
Peeked over the ledge where the blue smoke curls,
And I can tell you, boys and girls,
The world is FLAT.”
— Shel Silverstein

It started one October, a few months into a new school year. The little boy grew moody and restless.
He erupted into volcanic rage, screaming and throwing chairs. He cursed like a sailor. During recess, he climbed over a playground fence and bolted for nearby woods.
Then one day, in a fit of anger, he did something worse. Out of the classroom, he flew down the hallway and through the school’s double doors.
A teacher caught up by the parking lot’s edge. Chance Roth was going to launch himself beneath the wheels of a yellow school bus.
He was 3½ years old. He wanted to die.
A tinge of disbelief still colors his mother’s voice. “He had never experienced any trauma,” Sherri Cook says. “He had never been to a funeral. He had never experienced a death. We didn’t know where this was coming from.”
Or where it would lead.

Afternoon sunlight bathes the front room. Ms. Cook sits, hands folded, at a dining table in her tidy Festus home.
For the moment, Chance is perched on the edge of a straight-back chair, listening as she tells his story.
“I don’t remember that,” he says softly.
“You were very young,” his mother reminds him.
Chance’s pediatrician suggested that the family find psychiatric help. Even with private insurance, it was difficult.
Ms. Cook called more than a dozen doctors, some as far away as St. Charles County. But most of them did not treat children. Those who did either had no openings or did not accept her insurance.
She finally found care for Chance at a Jefferson County treatment program called Comtrea. That makes him one of the lucky ones.

In the best of times, many Missourians with serious mental illness cannot get the help they need. With state revenue plummeting, these are far from the best of times.
The House of Representatives recently passed a budget that slashed millions of dollars from the state Department of Mental Health. It falls about $43 million short of what would be needed to maintain current services.
Unless the Senate adds more funding, waiting lists for care will grow, and some Missouri families will be left out.
Even as lawmakers cut spending for mental health, they have refused to tap millions of dollars provided through the federal stimulus bill. That money could free up state dollars to pay for desperately needed community psychiatric care and other mental health programs.
But Rep. Allen Icet, R-Wildwood, chairman of the House budget committee, is “philosophically opposed” to using federal stimulus money to expand Medicaid coverage.
Political philosophy is well and good. But kids like Chance — and thousands of adults who used to be kids like Chance — need help now. It is unconscionable to let anything, especially political philosophy, stand in the way.

A few months after he turned 5, Chance was diagnosed with bipolar disorder. At the time, his family had private health insurance, but the coverage was limited. Now Medicaid pays for Chance’s care.
It includes counseling and medication that controls his worst symptoms. But control is a relative concept.
People with bipolar disorder can veer wildly from deep depression to an almost-reckless impulsiveness. Even on a peaceful spring day, Chance is a squall threatening to erupt.
He bursts out of the living room, interrupting his mother to announce that he is going to visit a relative nearby.
“You can’t go right now, honey. I’m talking. I can’t take you,” Ms. Cook says patiently.
Back into the other room he goes. But a moment later, he again is headed for the front door to leave.

Chance will turn 10 later this month. Not long ago, his counselor asked him to start keeping a journal.
Some of the entries are heartbreaking. “He writes about how alone he feels, about how he hates himself for the way he sometimes acts,” his mother says.
With a little prompting, Chance offers to bring it out. But when he comes back, he is holding a tattered children’s book, “Where The Sidewalk Ends,” by Shel Silverstein.
“This is my favorite poem, ‘The Edge Of The World,’” he says.
Like any other third-grader put on the spot, he reads haltingly and with an awkward rhythm. “For I’ve been down to the edge of the world,” he intones.
What is it he likes most about the poem? Chance shrugs. Maybe he’d like to visit the edge of the world some day, to peek over the ledge where the blue smoke curls.
Maybe he already has.

— John G. Carlton