Children’s behavioral health is a topic 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 percent 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 America 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 continues to be the second 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 percent 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 percent 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.”
How Will Children’s Behavioral Health Change in 2017?
The federal government appears on track to eliminate the improvements to mental health services made by the ACA. However, until the final ruling comes down from Congress and the Oval Office, people can still enroll in health insurance through the Health Insurance Marketplace. Of course, some states will continue to refute expansion of Medicaid, creating disheartening scenarios for parents and caregivers of children with mental illnesses.
Those eligible for coverage under CHIP can take advantage of the final ruling issued by the CMS. However, those outside of the income limits may be faced with the decision to forgo health insurance entirely due to rising premiums within the Health Insurance Marketplace. According to CNN, premiums for individuals seeking coverage through the marketplace will rise at least 7 percent, but some states may see increases of up to 50 percent.
In Texas, my own premium will jump 41.7 percent for 2017. I am still uncertain as to if I will be able to keep my insurance. I cannot imagine the despair CHIP-ineligible parents may feel when making the decision to forgo coverage or face dramatic cost increases for their children with mental health illnesses.
Ultimately, if the ACA is repealed or premiums increase further, coverage rates of mental services for CHIP-ineligible children will likely drop as well.
What Does This Mean for Your Organization?
Access to children’s behavioral health services is only going to grow harder for millions of Americans. In your organization, providers need to start working 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.