How are the Kids Doing?

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How are the Kids Doing?

Steering Committee

May 01, 2024

Revisiting the status of children’s and youth’s mental health feels timely as we head to the end of another school year and as we observe Mental Health Awareness Month. We are now four years removed from the unprecedented shutdown of our regularly scheduled lives and in a place where we can look back and see how that period affected all of us, but most especially our children and youth. Most of the information and research results show that we continue to grapple with the long-term effects of the COVID-19 pandemic and the rising prevalence of mental health disorders among children and youth.

The latest statistics show that mental health challenges continue to affect one in five children.1 What the numbers also show is that lack of access to treatment continues to affect two-thirds of individuals who need treatment.2 The lack of access to care can have a profound impact on the life trajectory of children and youth. Untreated mental illness can lead to children and youth dropping out of school, involvement with the juvenile justice system, and even loss of life as suicide remains the second leading cause of death for those between the ages of 10-24.3

We know that early identification and intervention works, and we also know that most people who will develop a mental health disorder will experience symptoms by age 14 therefore it is important for us to work together to identify any child/youth that might be exhibiting symptoms and refer them to treatment. Waiting to address these challenges can have a significant emotional and financial cost for families.

A recent study, released in March of 2024 looked at the:

  • Prevalence of mental health diagnoses and total medical spending from 2017-2021 for children aged 5-17. The study found that:
    • Mental health diagnoses rose by almost 22%.
    • The overall mental health costs to families rose by 31%.
    • Pediatric mental health conditions accounted for almost 50% of medical spending for families in 2021.
    • This study estimates that in 2021 about one in four children was diagnosed with a mental health condition.4 This estimation is higher than the estimates reported by both the State of California and Mental Health America.

Both the federal government and the state of California have made significant commitments to provide metal health services for children and youth. The federal government has released funding opportunities to provide mental health services through the Substance Abuse and Mental Health Services Administration 5;  through the Department of Education, including the Bipartisan Safer Communities Act6, which includes funding to support mental health and student wellness in schools, and through a public education campaign to reduce stigma and encourage children and youth to seek help when needed. One of the federal government’s most significant changes has been to the suicide and crisis intervention lifeline.7

This lifeline is meant to provide immediate assistance to anyone in the middle of a crisis or experiencing emotional distress. Transitioning from a ten digit to a three-digit number was a step forward in attempting to strengthen the crisis care system in the country. People can now reach out for help by simply dialing 988. Since its release in July 2022, 988 has received approximately 9.6 million calls, texts, and chats. The average number of calls per month is close to 457,00, the average time to answer a call, chat, or text is 47 seconds and the average length of the contact time is 22 minutes. The general trend of incoming calls has risen since the inception of the 988 number, the average time to answer has decreased and the average length of time of the contact has risen slightly. The 988 has also implemented specialized lines for Veterans, for individuals who identify as LGBTQI+, and for Spanish language speakers.8

The governor and the state have also made a commitment to children’s and youth mental health services through the governor’s Master Plan for Kids’ Mental Health (MPKMH). The MPKMH addresses the heavy toll being shouldered by the children and adolescents in the state of California as evidenced by the following:

  • Over 284,000 youth cope with major depression.
  • 66% of kids with depression do not receive treatment.
  • Suicide rates for kids ages 10-18 increased 20% between 2019-2020.9

In “The State of Mental Health in America” report for 2023 from Mental Health America (MHA), California has an overall ranking of 19th out of 51 (for all the states and the District of Columbia) as a measure of a lower prevalence of mental illness in comparison to access to care.10 In this same report, for youth California ranks 28th out of 51 (for all the states and the District of Columbia) as a measure of a lower prevalence of mental illness in comparison to access to care.11 California also ranks 20th for youth with private insurance that does not cover mental or emotional problems. 12

One of the most striking findings in MHA report is the fact that only .718% of students with an Individualized Educational Plan (IEP) are identified as having an emotional disturbance (ED) for youth diagnosed with a mental or behavioral health condition that affects their educational performance. Of note is the fact that the identification of students with ED may contribute to disparities for marginalized youth as 7.25% of multiracial youth with a disability and 6.25% of black youth with a disability are identified with ED, compared to 5.15% of all students. Youth identified with ED are more likely to have experienced trauma, including poverty, and are more likely to experience disciplinary removals from schools. California ranks 43rd out of 51 in this category, making poorer outcomes more likely for California’s students.13

Part of the governor’s MPKMH includes the Children and Youth Behavioral Health Initiative (CYBHI). The CYBHI contains four strategies:

  1. Workforce Training and Capacity
  2. Behavioral Health Ecosystem Infrastructure
  3. Coverage
  4. Public Awareness 14

 

Each of these strategies is launching new programs and initiatives as well as strengthening existing efforts statewide. California is in the middle of redefining the way we serve children, youth, and families. The strategies employed are laying the groundwork and infrastructure to support a more youth-centered, accessible, equitable, and organized system of care. Just one of the features of the CYBHI is a series of grant funding opportunities for community partners to receive funding to train staff in evidence-based programs (EBP). The Desert Mountain Children’s Center has applied for and received funding to train our staff in several EBPs and is in the middle of implementing training for staff to better serve the children and youth in our programs.

As we close out this school year, we look forward to working with you, our partners, in continuing to design, innovate, and implement a managed system of care that meets the needs of the children, youth, and families we serve, particularly those who are impacted disproportionately by behavioral health issues and face the greatest systemic barriers.

References:

  1. Children's Mental Health
  2. 4. (Loo TM, Altman M, Bravata DM, Whaley C. Medical Spending Among US Households With Children With a Mental Health Condition Between 2017 and 2021. JAMA Netw Open. 2024;7(3):e241860. doi:10.1001/jamanetworkopen.2024.1860)
  3. Grants Dashboard
  4. U.S. Department of Education Announces More Than $188 Million from the Bipartisan Safer Communities Act to Support Mental Health and Student Wellness
  5. Congress Bill
  6. 988 Lifeline Performance Metrics
  7. Governor Newsom's Master Plan for Kids' Mental Health 2022
  8. 10. Reinert, M, Fritze, D. and Nguyen, T. (October 2022). “The State of Mental Health in America 2023,” Mental Health America, Alexandria VA, page 9
  9. 11. Ibid, page 12
  10. 11. Ibid, page 27
  11. 11. Ibid, page 28
  12. Implementing the Vision

Resources:

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