Two years ago, paediatricians, child and adolescent psychiatrists and children’s hospitals joined together to declare a national emergency in adolescent mental health. As our country navigated the COVID-19 crisis, we saw a parallel health emergency growing among our nation’s youth – one that predated the pandemic.
Fast forward to where we are today, and while we’ve seen some policy progress, there is still so much more we can and must do to support the healthy mental and emotional development of young people.
Survey data released this year by the Centers for Disease Control and Prevention shows that in 2021, nearly 60% of teen girls had recently experienced persistent sadness or hopelessness, and nearly one-third of high school girls had recently considered suicide. About 3 in 10 high school students had experienced poor mental health in the past 30 days, while 22% had seriously considered suicide in the past year and 1 in 10 had attempted it.
Findings like these reflect the worrying trends we’ve seen in our clinics, practices and hospitals across the country. But while the figures are undoubtedly alarming, we cannot see them as insurmountable or irreversible. Instead, they must galvanise us into action.
Our organisations – including the paediatricians, child and adolescent psychiatrists, nurses, mental health providers and children’s hospitals we represent – share a common mission: to ensure that young people get the best possible care to live their healthiest lives. We are committed to working with patients and families to identify effective interventions and preventative measures to address health challenges.
It is time for our government leaders to take the same solutions-oriented approach to supporting young people’s mental health. We know the types of interventions that work, but we need urgent action and significant investment across the continuum of care to see actionable progress.
First, to best support the mental health of all young people, we need to start earlier in their lives. This means investing in prevention and early intervention services that help young people before a condition becomes serious or even life-threatening.
Currently, if a young person is struggling at home or at school, they may face significant barriers to accessing mental health services. Congress must fund programs that help prevent, delay, or mitigate the effects of mental health problems in children, including those without a mental health diagnosis, and ensure that existing federal investments – such as the Community Mental Health Services Block Grant program – can support the prevention and early intervention services that children need most.
We also know that the severe shortage of mental and behavioural health professionals trained to meet the unique needs of children further impacts young people’s ability to access timely care. Families often face long waits for appointments and may have to travel long distances to receive care. In some cases, children and adolescents go without treatment, which can lead to a mental health crisis.
We need federal and state policymakers to invest in innovative ways to train existing and new providers to address the continuum of mental health care, while also prioritising ways to build a more diverse mental health workforce. This includes addressing inadequate payment rates for behavioural health services, which make it even more difficult for child and adolescent psychiatrists and other mental health professionals to sustain careers in these fields. And it means paying primary care paediatricians – who are the only outpatient physicians for about one-third of US children with mental health problems – for the mental health services they provide.
We need to expand community-based options across the continuum of care and integrate medical and behavioral health services into primary care. For example, limits on same-day billing in public and private insurance mean that a patient may not be seen by both a medical and mental health provider on the same day. This not only hampers care, but also places an unnecessary financial burden on the patient and family – and in some cases leads them to forgo needed care.
We know what we need to do to support young people’s mental health. But we need our government leaders to help bring about change beyond our own consulting rooms.
We call on policymakers to take meaningful action to provide young people with the mental and emotional health support they need.
