More resources needed for America’s youth mental health crisis

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“Mental illness and general mental health struggles affect nearly every teenager in the country. I’ve personally struggled with OCD and anxiety for many years. I would love to see more representation and interest in mental health in the government, because mental health is an issue that affects everyone.” – Teen patient at Nemours Children’s Health

When the COVID-19 pandemic began over two years ago, we didn’t know its impact on our physical, emotional, or mental health. We learned a lot over the past two years about managing the virus, but the pandemic didn’t only create new problems — it shined a spotlight on, and in many cases, worsened existing problems. This was especially true for mental health services across the country. Hospitals and mental health providers were already dealing with limited capacity before the pandemic. These past few years have pushed it to a breaking point. And while we know that Americans of every age faced mental health challenges, our children were dealing with a rapidly changing world, remote learning, and increased isolation.

According to the U.S. surgeon general, before the pandemic, up to one in five children ages 3 to 17 years old had a mental, emotional, developmental, or behavioral disorder. The challenges that came with the COVID-19 pandemic exacerbated these conditions in our children. For example, Nemours Children’s Hospital in Delaware saw an 80 percent increase in patients for suicidality or intentional harm as compared to 2020. Due to similar circumstances nationwide, the U.S. surgeon general issued the first-ever public health advisory on the youth mental health crisis, an advisory usually reserved for urgent issues that need immediate attention. We commend the surgeon general for joining the nation’s leaders in pediatric care including the American Academy of Pediatrics, Children’s Hospital Association, and the American Academy of Child and Adolescent Psychiatrists for sounding the alarm on the youth mental health crisis in America. We also appreciate that across multiple congressional committees with health jurisdiction, we have seen a series of hearings and bipartisan bill introductions that would make a meaningful difference for the mental health of our nation’s children.

When the pandemic began, children were exposed to unprecedented pressures including dramatic changes in their daily routines, education, home life, and communities. Lockdowns, quarantine, the sudden shift to online learning, lack of social interaction, and the increase in social media consumption — are just a few of the outside pressures children faced during the early part of the pandemic that took a toll on them. They also had to watch as their families were impacted by the hardships of the pandemic such as the shortage of safe and affordable housing, economic insecurity, and even the loss of a parent or grandparent to the virus. Combined, these issues fueled a pervasive youth mental health crisis, one that disproportionately affects communities of color, rural areas, and families with low incomes.

At the same time, waitlists in primary care for a broad range of developmental, psychological, and psychiatric services grew. Increased duties for school counselors and nurses to manage COVID-related illnesses among students prevented their ability to identify and manage mental health concerns. There’s an increasing number of children and youth who are left waiting for significant periods in the emergency department for placements and external referrals — a phenomenon known as “boarding.”

This landscape made clear the need for additional children’s mental health infrastructure in America. And now, it’s time for Congress to enact legislation to address this crisis. We need to give hospitals resources to expand capacity for pediatric behavioral and mental health services, improve behavioral health care integration and coordination, fund community-based activities, and support training and workforce innovations in pediatric health settings to meet our children’s needs.

There are three pieces of bipartisan legislation in Congress right now that would do just that. H.R. 4943, the Children’s Mental Health Infrastructure Act, H.R. 4944, the Helping Kids Cope Act, and H.R. 7236, the Strengthen Kids’ Mental Health Now Act. Collectively, these bills, all introduced or co-sponsored in the U.S. House of Representatives by Rep. Blunt Rochester, would improve access to pediatric mental and behavioral health services, increase Medicaid reimbursement for pediatric mental health services, promote pediatric mental health, and support the mental health workforce and care coordination efforts that the surgeon general recommended. These bills would also support community-based solutions like school partnerships and community health workers working with pediatric providers for urgent care, ongoing treatment, and follow-up. They also support telehealth services for mental health treatment — a lifeline used by many individuals throughout the pandemic to access care online.

We can manage and prevent mental health challenges with the appropriate attention and resources. We have to set our children up for success, and that starts with making sure they have access to the help and the tools they need to live long, productive, and happy lives. Today, we call on Congress and the Biden-Harris administration to prioritize the need for more funding and resources to combat this crisis because when we invest in our nation’s children, we’re investing in our future.

Lisa Blunt Rochester is Delaware’s sole member of the U.S. House of Representatives and serves on the House Energy & Commerce Committee. Kara Odom Walker, MD, MPH, MSHS, is chief population health officer for Nemours Children’s Health System.

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