The mental health crisis facing young Americans requires health care reforms

The statistics are rough. The average wait for initial assessment, ongoing therapy, and medication services is longer for children than for adults. For an adult who may typically wait 12.7 weeks for therapy, the child may be delayed for more than 15 weeks.

Meanwhile, the idea of ​​suicide in young people has been on the rise since 2009; suicide is the leading cause of death in children aged 10 to 14 years. The mental health of young Americans has been deteriorating for years, but the COVID-19 pandemic has worsened the crisis a lot. Millions of children have suffered social isolation as a result of school closures and the loss of loved ones due to illness, widening the gap between the demand and supply of mental health services.

The most notable problem with the mental health care of children and adolescents is the lack of hospital beds. On a Monday in March, 503 adults and 247 children were waiting in bed at a Massachusetts psychiatric facility. More beds in psychiatric facilities would mean that the most vulnerable children would not have to spend another night in an emergency room.

But extra beds will not reach the source of the problem if the number of people entering the behavioral health area of ​​children and adolescents – along with psychiatrists, nurses, counselors, social workers and psychologists, but not only – does not match the growing number. the number of children in need of care.

Although hospitals are struggling to hire doctors and doctors, more and more are coming out. For every 10 outpatient clinics that go into mental health clinics, 13 outpatient clinics come out. It is essential to serve children in outpatient clinics: early mental health needs can prevent them from having to undergo later hospitalization.

The main reason for leaving suppliers is low wages and benefits to increase the workload. It includes the entire adolescent mental health care system, from the child to the school, family, teachers, therapists, and the community.

“Because our culture doesn’t value mental health care, and because returns are set in a way that reflects our culture, we’re looking at people who smoke and go away,” said Dr. Patricia Ibezia of Boston Children’s Hospital. The fact that insurers do not properly value outpatient mental health services leads physicians to leave the field or work privately, and as a result, they have become less accessible.

Another concern of Boston psychiatrists is that insurance companies, which have the ultimate authority to allow different models of child care, are not well aware of children’s mental health needs.

As difficult as licensing a routine medical procedure is, it is significantly more difficult for insurance companies to demonstrate the importance of different methods of behavioral care, such as outpatient intensive care therapy, virtual group therapy, or dialectical behavior therapy.

Mental health, especially in children, has not been recognized for centuries as a stigma against mental illness. Now that politicians are catching on, it would be good to keep in mind that children of color and LGBTQ youth suffer even higher rates, and that the number of mental health providers is also not growing fast enough.

It’s been a breakthrough on Beacon Hill, but it may not be enough and it’s certainly not fast enough.

Parliament has put some money into COVID’s federal promotion program for mental health, and last year the Massachusetts Senate passed its Mental Health ABC Act 2.0. The law puts more teeth on the requirement that mental health and primary care providers be reimbursed at the same rates for the same service; eliminates prior authorization requirements for acute treatment; and promises that mental health care insurance coverage is equivalent to insurance coverage for other medical conditions. The House of Representatives should pass this law immediately.

Then there’s the Thrive Act, a school-based behavioral health legislation that requires public schools to prescribe physical and mental health education for all students based on age. This is also awaiting approval in the House.

Finally, there is a push from Governor Charlie Baker to improve access to health care: This bill requires providers and insurers to increase primary care and behavioral health by 30% over the next three years.

All proposals have some overlapping policies. But any legislation derived from the various plans floating in Beacon Hill would be an improvement in the health care system that has left too many children in crisis.


Editorials express the opinion of the Boston Globe Editorial Board. Follow us on Twitter @GlobeOpinion.

Leave a Comment