Suicide is the third-leading cause of death among young people. More than two-thirds of youth in the juvenile justice system have diagnosable mental illnesses. By any measure, mental health problems have a devastating impact on
America’s children. It is time for Congress to give this crisis the attention it warrants.

Many Americans believe that if their child were to require a specialist in children’s mental health assessment and treatment, a suitable provider would be but a phone call away, much like their pediatrician. Too many parents I have encountered have discovered the painful and frustrating reality that even children in crisis are often told to wait months for an appointment.

As a result, each year tens of thousands of parents make the heart-wrenching choice to turn over custody of their children to state bureaucrats as the only way of ensuring their treatment. Others see their children arrested — among the 80 percent of juvenile offenders with mental illnesses. Still others pay the ultimate price, burying children who might have lived had they only had proper treatment.

These tragedies occur because we have ignored the call to action from our nation’s leading experts in the field of children’s mental health. Expert panels like the president’s New Freedom Commission on Mental Health have warned of crippling shortages of clinicians, especially in rural areas and among certain specialties, such as those with expertise in trauma and child abuse, school and community violence, eating disorders and autism.

The Child Healthcare Crisis Relief Act (H.R. 2073) will help bring new professionals into the pipeline.  The bill creates educational incentives such as grants, scholarships and loan forgiveness programs to encourage more professionals to enter and remain in child and adolescent mental health. It would also support institutions of higher learning in their efforts to enhance and prioritize children’s mental health issues in their curriculum and training opportunities.

While legislation like the Child Healthcare Crisis Relief Act must be a component of any comprehensive approach, it is not the entire solution. The shortage in child mental health care providers exists not only because there are too few specialists in this field, but also because there are too many children who require their services. To address that problem, we must focus not only on treatment, but also prevention.

Fortunately, there is a tremendous amount of research that provides insight into the specific causes of childhood mental illness. The Kaiser Foundation’s Adverse Childhood Experiences (ACE) study, for example, demonstrates that a child who has witnessed serious violence, lives in a household with an alcoholic or drug addict, or whose mother is clinically depressed is at high risk of developing mental health or substance abuse disorders later in life. It shows us that children with such risk factors are twice as likely to become alcoholics as children with no risk factors and four times more likely to commit suicide. The Human Genome Project and the National Children’s Study, which needs stronger congressional support, offer the prospect of further explaining how and why certain children develop mental illnesses and other diseases.

We can and should use this knowledge to proactively seek out at-risk youth and implement early interventions that will reduce costs, both human and economic, down the road. Despite our growing understanding of the science associated with childhood mental illness, however, states constantly struggle to find federal dollars to implement proven interventions.
Instead, health programs like SCHIP and Medicaid base eligibility largely on family income, to the exclusion of other known risk factors.  Few federal programs are geared toward prevention or early intervention, and those that are have not incorporated the recent explosion in science about children’s brain development.

Rather than wait for the painful downstream consequences of inaction, states should be given the freedom to target children on the basis of known risk factors. Legislation that I will soon be introducing would give states the flexibility to directly target Medicaid services to those young children who are at the greatest risk. Furthermore, it would allow states to provide the kinds of family-based, early intervention services that we know are effective but that the federal government has been slow to embrace.

The existing Foundations for Learning program at the Department of Education similarly makes competitive grants to community organizations that provide family-based early education services to these same children, but has been woefully underfunded. In its first year, Foundations for Learning received 158 applications for only four grants. This program should be fully reauthorized in this year’s No Child Left Behind reauthorization and better funded in the future.

We are currently failing children and their families twice: ignoring science that can help keep children healthy and then rationing treatment when they get sick. The challenges are great, but the opportunities for improvement are abundant. We just need the foresight and political will to pursue them.


Kennedy is a member of the House Appropriations Committee.

SPECIAL SECTION: Childrens Initiatives
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