For our nation’s youth, the prevalence of mental health conditions was already growing at alarming rates when a generation-changing pandemic further exacerbated the challenge. In March, a report by the Centers for Disease Control and Prevention reported that 37% of high school students experienced poor mental health during the pandemic, 44% experienced persistent feelings of sadness or hopelessness, 19% had seriously considered attempting suicide, and 9% had attempted suicide. However, a recently published survey of pediatric primary care providers found that more than 85% of practices could not access adequate behavioral health support for their patients.
In President Biden’s State of the Union Address, treating children’s mental health was identified as a major priority, suggesting that there be “full parity between physical and mental healthcare if we treat it that way in our insurance.” And in late 2021, Vivek Murthy issued the Surgeon General’s Advisory on Youth Mental Health, calling for immediate awareness and action to an urgent and significant public health challenge.
Solving the mental health crisis for America’s youth requires simultaneous intervention at many levels. This summer, the U.S. Senate has considered 2 pieces of legislation (the first of which was passed in June), which would improve funding access to support children’s behavioral health through 3 primary vehicles:
- The Safe Communities Act, signed into law on June 25, provides nearly $300 million (FY22) for pipeline development into behavioral health careers and $1 billion (over the next 5 years) in mental health support for public schools, which includes more dollars for school-based mental health professionals, such as psychologists and counselors.
- The Investing in Kids Mental Health Now Act, a bipartisan bill introduced to the Senate on August 3, proposes increased Medicaid payments for pediatric mental, emotional, and behavioral health services, which includes telehealth access. The bill also directs the Centers for Medicare and Medicaid Services (CMS) to issue guidance to states on best practices to streamline licensure and credentialing across state lines, and how to expand crisis care capacity quickly when there is an uptick in demand for care.
Why It Matters
The promise of this new legislation is the multiple intended interventions to meet the challenge. As we wait for additional guidance and funding availability, there are several points healthcare leaders can consider now.
Creating access to behavioral health outside bricks and mortar: Digital health solutions can be an important strategy for health systems to enhance access to behavioral health, which lays the groundwork for expanded scope, scale, and efficiency of services.
- Managing Emergency Department (ED) throughput for behavioral health patients: In July, a new national behavioral health crisis hotline number 988 was established to provide ready access to a call center staffed by trained personnel. This will increase the already unprecedented demand for behavioral health crisis services. Some leading healthcare organizations are deploying behavioral health innovations in the ED to provide support, training, and tools that enable ED clinicians and staff to improve the care for patients with behavioral health conditions, including reducing time, length of stay, and admission/readmission rates.
- Expanding the mental health workforce: There is a serious shortage of behavioral health clinicians across the U.S., with the greatest impact on rural communities, low-income communities, and communities of color. The shortages impact an estimated 132 million Americans, with more than 6,600 mental health practitioners needed to fill vacancies. Working in partnership with the community, healthcare leaders are finding creative ways to build their pipeline to meet the moment.
- Leveraging Medicaid across different care modalities: According to a Kaiser Foundation Report, Medicaid plays a key role in covering and financing behavioral healthcare. Ensuring access to services through improved Medicaid reimbursement, including for telemedicine behavioral health visits, will be critical for health systems to address the demand. Other assessment and treatment modalities, such as telemedicine, also reduce familial stress and the resource burden on hospitals.
- Supporting or partnering with school-based programs: One in every 6 children aged 6-17 has a behavioral health disorder, and 50% of all behavioral health conditions begin by the age of 14. Early identification and treatment are critical for children to optimally learn and develop. School-based services are an important option for many adolescents who otherwise would not have access to community-based behavioral health services. This includes providers who are school psychologists, school counselors, school social workers, and school nurses who provide a support ranging from screening to provision of services within the school. Health systems can play a variety of roles, including providing technical assistance and training to school staff, children, and parents, as well as provide links to community and health system resources.
Children’s Hospital Association:
Strengthen Kids’ Mental Health Now Bill Would Invest in Mental Health
The White House Briefing Room:
Biden-Harris Administration Announces Two New Actions to Address Youth Mental Health Crisis
The Annie E. Casey Foundation:
2022 Kids Count Data Book: 2022 State Trends in Child Well-Being
American Psychological Association:
U.S. Youth Are in a Mental Health Crisis—We Must Invest in Their Care
The Commonwealth Fund:
Expanding Access to Equitable Behavioral Health Services
Creating the Mental Health Workforce of the Future
National Academy for State Health Policy:
States Take Action to Address Children’s Mental Health in Schools
Editorial advisor: Roger Ray, MD, Chief Physician Executive.