In 2017, I campaigned in every corner of Alabama, listening to people’s hopes, dreams and fears. I heard about jobs, education and college football (I was in Alabama, after all), but I was surprised to hear sobering statistics and heart-breaking stories about the dramatic increase in mental health concerns.
Particularly disturbing were reports about the rise in depression, anxiety, loneliness, trauma and suicidal thoughts among our youth.
As a member of the Senate Committee on Health, Education, Labor and Pensions, I worked with Democrats and Republicans on several bills to address the urgent needs I was seeing, but I knew this problem demanded a more comprehensive solution.
Then the pandemic hit and an already dire situation became desperate.
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The American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics and the Children’s Hospital Association recently declared a national emergency for child and adolescent mental health. And the U.S. surgeon general issued an advisory last month on mental health challenges for children, adolescents and young adults.
A Centers for Disease Control and Prevention report shows that beginning April through October 2020, emergency mental health visits for those ages 12-17 increased by 31% over the same period in 2019. For children ages 5-11, it was up 24%.
Data also shows a significant increase in the severity of those concerns during the pandemic. In the first half of 2021, children’s hospitals reported 45% higher rates of self-injury and suicide in children ages 5-17 than the first half of 2019.
The rate of suicide for Black children under 13 is twice that for white children, a statistic that demonstrates a disturbing disparity in access to timely, appropriate services.
And a recent study of 2,000 military dependent teenagers revealed that only 13% indicated a high level of mental well-being.
Treatment options are inadequate
Despite this urgent need, few pediatric behavioral health psychologists are accepting new patients, and the average wait for an appointment is 43 days. The costs of treatment can be staggering, because only half of child psychologists accept insurance. Forty-five percent are considered “out of network,” costing parents from $150 to 300 per hour. Just imagine being the parent of a child in crisis and having nowhere to turn.
Since leaving the Senate, I have heard from parents and health care providers who are simply overwhelmed. I began working with Children’s Hospital of Philadelphia, a globally prominent pediatric hospital system helping to lead efforts to respond to this crisis, and with Inseparable, a coalition trying to improve mental health care policy.
Children and adolescents respond best when mental health care is targeted to need, evidence-based, only as restrictive as required for safety, and closest to home. Comprehensive investments must address the whole continuum of care, so that the right types and levels of care are available.
4 ways government can help
Our government could help in these four areas:
►Reimbursement. Improve reimbursement across the full continuum of services, and enhance student loan forgiveness for people pursuing careers in mental health and substance abuse disorder services.
►Telehealth. Increase telehealth for mental health and substance abuse disorder services, especially in Medicaid programs and across state lines, so providers can reach underserved, rural and minority communities.
►Prevention. Fund more community-based mental health and substance abuse disorder programming and care in schools, neighborhoods and doctors’ offices, to help children build resiliency and reduce hospitalizations.
►Crisis response. Stop criminalizing mental health issues and lift the burden from law enforcement by expanding behavioral health crisis services and covering these services for all patients.
This is not a partisan plea. Our children’s mental well-being is unrelated to their parents’ political affiliations, but it is inextricably tied to our nation’s future well-being. The likelihood of lasting harmful complications increases every day that a child’s mental health or substance abuse disorder goes unaddressed.
I urge officials at all levels of government to work together now to implement policies and programs that will improve the lives of millions of young Americans suffering from mental health and substance abuse disorder challenges. We don’t have a moment to lose.
Doug Jones, who served in the U.S. Senate from 2018 to 2021, is counsel at Arent Fox LLP.