“What weighs on me the most as a pediatrician is that adults with mental illness say their symptoms began in childhood and we missed most of them when they presented in front of us…More children in Texas suffer from mental illness than we would otherwise expect, which really speaks to the unfortunately hidden nature of these conditions.”
Anu Partab, MD, Pediatrician
Testimony, House Select Committee on Mental Health, March 22, 2016
Half of all chronic mental illness begins by age 14 and seventy-five percent by age 24.
Please take a moment and let that sink in. It is a startling statistic and one that should not be ignored.
Last week, I was in Austin for the House Select Committee on Mental Health hearing, where the focus was child and adolescent mental health. We spent several hours hearing from health care providers, educators and others on the frontline of this critical issue. It quickly became clear that while many in our state are doing great work and finding innovative ways to address this issue, there is much more that needs to be done.
I am still processing much of what was said, but my initial takeaway is this: it is critical that we improve access to care, increase early intervention and find innovative ways to address an overwhelming need. Ultimately, the more resources we bring to bear to address children’s mental health care — time, money and people — the more likely we will achieve better educational outcomes, lower rates of incarceration and keep more of our neighbors off the streets.
The first step is to increase access to care. According to the Meadows Mental Health Policy Institute, in Texas each year more than 525,000 children experience severe mental health needs. Thirteen percent of youngest kiddos — ages 2 to 7 — have a mental, behavioral or developmental disorder. With a shortage of child psychiatrists and other providers, many of these kids and their families simply do not have the ability to access care. This isn’t isolated to children; the lack of providers, as well as a lack of mental health coverage, extends to adult Texans as well. We must focus more attention on training and retaining mental health providers, as well as decreasing the stigma associated with receiving mental health care.
The second step is to focus on early intervention. The American Academy of Pediatrics (AAP) recommends that children receive an annual mental health screening as a part of their well-check. Based on information provided during the committee hearing, children accessing care through Medicaid only receive one screening between the ages of 12 and 18. I brought this issue to the attention of the state’s Medicaid director and asked why the state was not following the AAP’s guidelines. This must be addressed and it’s an issue I will continue to push. We must also ensure that educators and other school staff have the tools they need to be able to recognize mental health concerns and once they do, have a place to refer a child in need of care.
Finally, we must share best practices, as well as find new and innovative ways to address this issue. We heard testimony from representatives from several school districts who have partnered with private counseling centers or the local mental health authority and brought mental health care services to their school campuses. The impact of these counseling centers has been incredible, and according to those who testified, has resulted in higher graduation rates, lower suspension rates and a more positive atmosphere on the campuses served. Funded largely through 1115 Waivers, these programs may not work in every community, but are definitely a step in the right direction and the model should be shared across our state. It is this sort of outside-the-box thinking that is needed.
Children’s mental health should be a top priority during the next legislative session. If we take real steps to address this issue and make the investments needed, it will result in long-term success and positive outcomes for generations to come.
If you would like, we can discuss your thoughts in person at my upcoming Town Hall meeting on April 9 from 10:00 to 11:30 am at the Arlington Municipal Airport.