Why Are Children’s Mental Health Services Lacking in the U.S.?

The lack of mental health and behavioral health services for youth are topics of concern among millions of parents and caregivers in the U.S. Unfortunately, tragedies and political discussions tend to obscure the sorrow and pain afflicting up to 20% of children ages 3-17, if not more, reports the National Alliance on Mental Illness (NAMI).

Meanwhile, the first study to review the prevalence of mental health illnesses and utilization of behavioral health resources among this group was only completed in 2011, explains the Centers for Disease Control and Prevention (CDC), and more recent results are not available. Statistically, attention-deficit hyperactivity disorder (ADHD) remains the most common mental illness affecting children, but this study’s finding could be askew because of parental influence and other confounding factors.

Making your services more available seems like the ideal solution, but you still need to understand the current state of children’s mental health services in the U.S. and why some avoid the topic entirely. However, you must also consider how access to these resources may change in coming months.

Current state of children’s behavioral health in America

An ideal behavioral health system would virtually eliminate any concerns over self-injurious behaviors, severe emotional disturbance or suicide. Sadly, suicide is the third leading cause of death among adolescents, indicating the current use of services is clearly not meeting the demand. In a recent survey of state agencies responsible for treating children with mental health disorders, reports Medical Xpress, researchers identified the following causes of the problem:

There is a shortage of qualified workers

Licensed therapists and behavioral health specialists for children seem to be in short supply. However, it is not known if this caused by few people completing educational requirements or simply choosing to work in adult behavioral health.

Services are spread out or unavailable

Each state is supposed to offer mental health services to children of low-income families, reports the Centers for Medicaid and Medicare Services (CMS). However, those who do not meet income requirements may be faced with challenges in accessing covered services under private health insurance.

Lack of public awareness breeds stigma-based assumptions

Parents or caregivers may have objections to seeking behavioral health services for their children. Religion, politics and financial worries can affect parents’ decisions.

Few data and quality assurance systems result in lost opportunities

The best-funded behavioral services are ineffective if treatment is discontinued against medical advice. Unfortunately, missing quality assurance programs have left many children to fall through the cracks, causing worsening of symptoms and possible expansion of illnesses into substance abuse as well. Although 50% of mental health disorders begin by age 14, most children and teens do not receive comprehensive treatment or intervention for eight years.

Most funding is given to adult behavioral health services

Funding for children’s behavioral health continues to be missing in private health insurance. While it is covered under the Children’s Health Insurance Program (CHIP), the CMS only finalized this rule in March 2016.

Implementation of Affordable Care Act (ACA) is disorganized

Up to 81% of behavioral health directors surveyed believe expanding Medicaid eligibility and making children’s mental health services part of the ACA’s Essential Health Benefits for private insurance plans would “improve accessibility and availability of services.”

What is being done?

As shown above, one of the key reasons why mental health services are deficient is due to a lack of accessibility. The inability to access children’s behavioral health services is a growing and obvious concern for millions of Americans. While more can and should always be done, the CDC has done work to address and bring awareness to these challenges. Some of their efforts include:

• Supporting solutions like Behavioral Health Integration (BHI) as an approach to improve access to mental health services for children and families
• Pilot testing programs in partnership with three universities to find more effective ways to educate behavior therapy providers by training professionals within the mental health field
• Creating state maps that show providers who can assess, refer or treat children’s mental health concerns
• Developing a policy report to help rural children with mental, behavioral or developmental disorders gain access to behavioral health services

What can your organization do about the lack of mental health services for youth?

Providers in your organization can begin to help prevent children from falling through the cracks by ensuring every employee understands the signs and symptoms of mental health disorders in children and teens. Implement new mental health training programs for identifying at-risk children and those already suffering, and understand a surge in people seeking services without financial responsibility is likely.

If parents or caregivers do not have the financial means to pay for services, you may need to explore other options, which may include submitting applications to Medicaid, CHIP and subsidies with the Health Insurance Marketplace. Essentially, children’s mental health services are facing a crisis, and you can do something about it by simply being present, making your organization’s services known in your community and always holding hope at the core of every treatment plan, application for services submitted and training.