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

April 11, 2013

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: 

  • West Virginia has implemented a statewide system that addresses prevention, early intervention and treatment and uses schools as an access point for reaching and serving children.
  • Connecticut has demonstrated the value of making emergency psychiatric services available via schools.
  • Massachusetts has expanded children’s access to mental health screenings through statewide health care reform.
  • Minnesota is working to overcome professional shortages in rural areas through tele-psychiatry. 
  • North Carolina has demonstrated the power of partnerships between mental health professionals and physical health providers to elevate the need for children’s mental health services on the policy-making agenda.

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
oaprice@gwu.edu

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