Column: Children’s mental health critical
Children’s mental health is one of the most important and most misunderstood issues in our national healthcare debate. Today, mental health care represents 38 percent of children’s Medicaid spending, which is used by just 10 percent of juvenile Medicaid patients. But the benefits far outweigh the costs. Today’s investments help to heal children and produce resilient adults. In the long term, effective treatments not only save lives but have significant economic benefits, including savings in the cost of education, unemployment, healthcare and incarceration.
Children’s mental health providers like Starfish Family Services know that too many U.S. children fail to receive the mental health care they need. This short-sighted approach damages children, families and society since mental health problems often grow more serious and expensive over time, with impacts in an array of settings. Within schools, mental health issues are often mistaken for discipline problems, learning disabilities, academic struggles, and ADHD. Later, these issues may lead to addiction, incarceration and unemployment. The long-term effects are especially concerning for children exposed to trauma. Ongoing trauma can change the chemistry of the brain and the body, leading to increased lifetime risks of chronic health conditions including cancer, heart disease, substance abuse, and other issues.
Fortunately, researchers and practitioners have developed effective tools to treat childhood mental illness, including early intervention, integrated mental and physical health care, family support and trauma-informed school programs. All these solutions are proven to help children heal today and to reduce the long-term social and financial costs of mental illness in the future. But these interventions are only feasible if we continue to protect mental health funding in our national and state-level healthcare and Medicaid debates. And, mental health treatment must remain a health insurance “essential benefit”.
Medicaid is important because children’s mental health issues are often caused by untreated parental substance abuse or mental illness. A prominent study has directly linked ‘Adverse Childhood Experiences’ caused by these family risk factors to chronic health conditions including cancer, COPD, coronary heart disease and shortened lifespan. Historically, there were few solutions for these families, since mental health funding was so limited. But the Affordable Care Act changed this by designating mental health an “essential health benefit,” and by expanding Medicaid coverage for low income families. These changes mean that children’s mental health clinicians can help children in crisis by referring their parents to urgently needed mental health care.
In addition to sustaining overall funding, we must continue to provide proven effective treatments. This is important as Michigan considers a plan to shift low-income mental health care to private insurers. Even if we change our insurance model, we must maintain our support for high-quality, proven effective interventions. Some would advocate for low-cost / low-quality solutions, such as increased reliance on medication and elimination of home visits. But data shows that these treatments have little success. They may save money today, but they will cost more in the future.
As we pursue quality care, we must do more to integrate children’s mental health care with other systems, including physical health systems. We can deliver highly effective treatment when behavioral health professionals work with physicians in their offices to treat the whole child. Furthermore, we must increase connections with parents and teachers – the adults who care for children every day. That is why Starfish now trains its teachers to provide “trauma-informed” education for its early childhood students, over half of whom have at least one indicator of trauma.
We know that these issues are serious and complex, and that our nation has limited funding. But we must continue to invest in children’s mental health care as we develop a path forward for healthcare in our country. Failing to do so will damage children and cost us more than it will save through avoidable expenses in our education, juvenile justice, criminal justice, unemployment, and long-term physical and mental health care systems. For the good of our children and our society, we must continue to invest in proven-effective, high-quality, age-appropriate children’s mental health care. That is why we encourage readers to call their Senators and Representatives, in both Lansing and Washington D.C., to ensure that any future health care reform protects quality children’s mental health care.
Marisa Nicely is vice president of clinical services at Starfish Family Services in Inkster.