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The Kids Are Not All Right: How 4 States Are Rushing to Improve Student Access to Mental Health Care


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Families, legislators, doctors and educators across the political spectrum are in agreement: children are not well.

Maryland, Colorado, California, and New Jersey are among the states that have recently passed laws expanding access to mental health care for young adults. New protocols and resources aim to provide care to those who need it most – particularly abused youth at home, and LGBTQ+ students.

In all four states, rates of young people with substance abuse and mental illness have worsened with epidemic isolation and inconsistent education. Nationally, only 8-9 percent of students of color with major depressive episodes received treatment, compared to 22 percent of their white peers.

“This worsening crisis in the mental health of children and adolescents is closely related to the stress caused by COVID-19 and the ongoing struggle for racial justice and represents an acceleration of trends observed prior to 2020,” an October statement from the American Academy of Child and Adolescent Psychiatry said, Read the American Academy of Pediatrics and the Association of Children’s Hospitals.

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But the increasing demand for services comes in an era of limited capacity. There are only about 9.75 child psychiatrists for every 100,000 young people under the age of 19. According to the AACAP, there should be more than four times the number available, especially as providers congregate in large cities. Most US counties do not have a single child psychiatrist.

The groups declared a national child mental health emergency late last month, and called for increased access and funding for telemedicine, mental health care in schools and workforce development programs for practitioners.

Some recent laws fund free treatment and depression screening for young adults. And in California, all middle and high school students in health class will learn about mental health and disease.

Historically, reforms at the state level have been slow to meet the needs of students. While Many like Wisconsin are now allocating federal relief money to mental health care in schools, and it’s not clear from the legislation which programs might take hold.

Between half and a third of American children experience trauma before adulthood. And for children ages 5 to 11, visits to the emergency room for mental health reasons increased 24 percent last year. The US Department of Education even published a reference report in late October to help teachers and schools better support children.

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Here are four ongoing statewide efforts to address the mental health crisis of youth:

Maryland

As of October 1, Maryland minors age 12 and older can consent to psychotherapy on their own. Previously, young adults needed to be as young as 16 to access mental health care without a guardian.

Advocates of the legislation assert that this will expand access to mental health care for LGBTQ+ youth, those living in abusive homes and those whose families may be stigmatized for mental illness and treatment.

Others, including the Maryland Council of Nursing and the Psychological Association, have expressed concern that 12 may be too young to make informed decisions about treatment, or that young adults may be suicidal without parental knowledge.

Providers can still ultimately choose to disclose treatment information to parents, unless they believe doing so will harm the minor or deter them from seeking care.

The law also requires health care providers to determine if a minor is mature enough to understand consent before starting treatment, regardless of age. Psychotropic medications cannot be prescribed to anyone under the age of 16 without parental consent.

California, Illinois, and West Virginia have similar laws that allow young adults under the age of 16 to obtain care without parental consent.

Colorado

All Colorado youths under the age of 18 now have access to at least three free mental health counseling sessions. No proof of insurance is required.

Counseling, mostly provided by licensed physicians via telehealth, is also available to youth 18-21 receiving special education services.

I Matter was made possible when state lawmakers appropriated $9 million for the effort — the Colorado Youth Mental Health Rapid Response Act was signed into law in June. I Matter was officially launched on October 27th.

To access the services, young people first complete an emotional health survey on the I Matter website. Funding for the interim initiative ends in June 2022.

“I’ve already pulled a bill to make this an ongoing program,” Representative Dafna Michaelson Jennett told Colorado Public Radio. “I think that’s something we need on an ongoing basis in Colorado.

Colorado has higher rates of youth mental health problems and substance abuse than 44 other states.

California

All health education classes in California middle and high schools must include mental health as part of their curriculum.

The state Department of Education will also make plans to expand mental health education in more schools by January 2024.

Over the next two years, teachers, parents, counselors and students will develop new protocols for schools to address students’ mental health needs. The protocols will cover how schools identify students who need support and how to handle external counseling referrals.

California has also joined forces with a handful of other states to reform their approach to truancy for mental health needs — state schools will now treat mental health-related absences as they do physical health concerns.

Policy reforms signed this summer and fall by California Governor Gavin Newsom were met with some criticism from conservative parents and politicians who were looking forward to seeing “less mandates come from Sacramento and more freedom.”

New Jersey

Beginning in the next school year, New Jersey youths in grades seven through twelve will have access to school depression screening.

If the examination shows that a student is depressed, the parents should be notified and provided with additional resources to support their child.

Counties will apply for state funding to facilitate checks and collect de-identified data, which will then be shared with the state’s Department of Education and the Department of Children and Families.

The American Academy of Pediatrics recommends that young adults 12 years of age and older be screened annually.

Reflecting on the rising suicide rates, Society member Carol Murphy and co-author of the bill said, “These tragic losses didn’t need – and shouldn’t have happened. We must be more proactive not simply react to tragedies, but prevent them before its occurrence.”

New Jersey also unveiled a central resource website at the end of September. The website’s welcome message acknowledges how common anxiety and stress are, and serves as a tool for young people and their families to access resources and behavioral care information.

“We ask parents to be aware of the signs – perhaps it is unusual changes in mood, increased and prolonged patterns of fighting or lying, or perhaps they are not enjoying activities they once enjoyed,” said Kristen Norbot-Bayer, Commissioner for Children and Families, in A state press release, “Don’t be afraid to ask your children what’s wrong, and normalize asking for help when they need it.”

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