Health Care and Education Reform: Make Room for Children’s Mental Health

5 Comments | Posted

makeroomThe children’s mental health system in America is as fragile as the vulnerable youth it is intended to serve. That is a troubling reality and greater collaboration between leaders in education and health care is essential. Here’s why and some thoughts on a few partnerships that show promise for the future.

Today, fewer than 10 percent of children identified as needing mental health care receive services within three months of that finding; fewer than half of those diagnosed with a serious emotional disorder ever get treatment from a qualified mental health professional.  Unlike children’s physical health services for which there is a robust private and publicly funded system, mental health services are much less well organized and funded.

Those statistics are unacceptable. The recent Government Accountability Office (GAO) report (Children’s Mental Health: Concerns Remain about Appropriate Services for Children in Medicaid and Foster Care, December 2012) highlights the challenges confronting both education and health care leaders as they respond to the leading domestic policy issues of the day. My colleagues in health care are sorting through the maze of regulations associated with the Patient Protection and Affordable Care Act, while those in K-12 education are up to their eyeballs in Common Core implementation and teacher accountability initiatives.

While I recognize the promise that both these reform movements hold for our nation, I am concerned that we are not addressing the critical need that requires collaboration among health care and education professionals at the federal and state levels:  children’s mental health.

A new study my colleagues and I have just completed with support from the Robert Wood Johnson Foundation) concludes that meaningful improvements will require state and local governments to address the system-wide barriers that result in widespread shortfalls in care.  Improving Access to Children’s Mental Health Services: Lessons from 11 States summarizes insights from interviews we conducted with 47 individuals from governors’ offices, state mental health agencies, education and health departments and child advocacy organizations in Arizona, Connecticut, Florida, Georgia, Massachusetts, Minnesota, New Mexico, North Carolina, Oregon, Texas and West Virginia.

However, our research also showed that while the underdeveloped state of children’s mental health services creates great challenges, there are bright spots in some states.  For example: 

While states are rushing forward with health and education reforms, those of us who care about the state of children’s emotional well-being need to make sure that new policies, programs and processes address the gaps in care that consign children and their families to unfulfilled futures. Greater collaboration is needed if we are to create a new children’s mental health system in America that gives our youth the attention they deserve.

Olga Acosta Price, Ph.D.
Director and Associate Professor
Center for Health and Health Care in Schools
The George Washington University, School of Public Health and Health Services, Washington, DC


  1. Garry Earles, LICSW's avatar
    Garry Earles, LICSW
    | Permalink

    Recently, in response to the report: Improving Access to Children’s Mental Health Care, I emailed Olga Price and forwarded an essay I’d written regarding child and adolescent mental health (C&A MH) entitled, The Ignored. Olga responded and suggested I post a few comments here about my concerns, so here goes.

    Mostly as a result of the Sandy Hook tragedy, C&A MH became a national agenda item. There was immediate talk about increasing budgets to provide more services to this vastly under served population, as if coughing up more money for services would do the trick, namely insure that youth would receive the help they need. Were it that simple.

    C&A MH is a highly specialized arena that requires specific expertise, expertise that is neither easily found nor developed. While many sincere and dedicated clinicians claim such expertise, in reality they are woefully ill prepared. Truth be told, there is a dearth of courses/programs that address C&H MH - not for clinicians and certainly not for educators who are, ever increasingly, the frontline of defense in “spotting” kids that need help.

    Before we supplement mental health budgets to provide additional services, we need to address other critical issues. Academic programs in C&A MH are rare, at the community college level as well as at the undergraduate and graduate level. Aspiring educators get no information on even basic C&A MH conditions. While it’s true that availability of services needs to be bolstered, we first have to have knowledgeable and competent personnel. They need to be trained and it’s never to early to start laying that groundwork.

    Now, let’s assume we develop the necessary clinical curricula. Once those aspiring clinicians enter the workforce they need to be supervised. Think about the expertise required to supervise and guide/develop competent personnel. Further complicating this picture is that, if you look around, professional development/training in C&A MH is virtually non-existent.

    To summarize, before we go off and advocate for more funding, we need to create an effective infrastructure that includes appropriate academic programs, competent supervisors and the availability of topical professional development offerings.

    By not addressing these aspects – Training – Supervision – Professional Development – I suspect we will be chasing our tails.

    In light of my concerns, I’d like to applaud the NYU Child Study Center for having an undergraduate minor program in C&C MH. The program is described on their website:

    If you’d like a PDF copy of my essay, please feel free to email me:

    Thanks for taking the time to read and consider my comments.
  2. Sue Burts's avatar
    Sue Burts
    | Permalink
    With the budget, wouldn't combining Peer Support out of the mental health offices, into the schools, help all the way around? Already background checked. Grant monies, access to support and help between schools, mental health, and families. And draw on all 3 budget areas, as well as insurance to balance a better outcome and organize? Just a thought.
  3. Evelyn Frankford's avatar
    Evelyn Frankford
    | Permalink
    Physical health care sits on a foundation of well child care and interventions. A focus on mental health "well child" care, for example, social and emotional development, would help to make clear the importance of linking health and education to promote optimal growth.
  4. Shannon Hall's avatar
    Shannon Hall
    | Permalink
    Thanks for highlighting this critical need!
  5. Travis Wright's avatar
    Travis Wright
    | Permalink
    Thank you for bringing this important issue to light. Though often devalued in high stakes educational environments, student mental health support is a critical component of academic success.

    Research consistently demonstrates that social-emotional health is a critical component of academic achievement. Given that many of the students who struggle most in school are navigating stressful life circumstances, such mental health support is especially necessary for their success. With millions of dollars being spent to develop new ways of assessing students, I can't help but wonder if this money would be better utilized to provide the mental health support they need to excel?
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