Seamless access to mental health services for children is essential, but too often not available. According to the National Institute of Mental Health, fewer than 20 percent of children who need it receive mental health treatment for emotional disorders which include depression and anxiety.
Children from homeless and underserved families suffer from a higher incidence of emotional disorders than the general population. Undiagnosed and undertreated mental health disorders such as depression strain a family's ability to handle the complex and sustained needs of children with chronic illneses such as asthma and diabetes.. The Children's Health Fund, through treating thousands of medically underserved children, has identified persistent obstacles that exist for children who need mental health services.
Insufficient funding of mental health services at the state and federal levels have restricted access to mental health services. Since 1990, appropriations to state mental health programs have declined. States have also implemented cost control measures such as limiting the development of new mental health services by focusing on dwindling budgets and tighter appropriations. Such restrictions impede the development or expansion of programs that serve people who are eligible for Medicaid, and slow the state's response to increased needs.
Coverage gaps in many private insurance plans prevent children from accessing mental health services. Many private insurance plans do not provide the same level of coverage as other health services. Varying co-payments and high deductibles, as well as caps on visits are imposed on individuals seeking mental health insurance coverage. Parity laws would eliminate inequitable treatment of individuals suffering from mental illness.
Workforce shortages in the mental health profession also restrict access. The U.S. Surgeon General has identified an acute shortage of mental health services professionals serving children and adolescents. Shortages of pediatric psychiatrists can result in delayed diagnosis or inappropriate treatment.
The Children's Health Fund advocates for policies and initiatives that will increase access to mental health services such as state and national mental health parity laws. To address disparate numbers of mental health professionals in underserved areas, CHF also supports initiatives such as increased reimbursement rates and scholarship programs to attract mental health professionals to underserved areas.
Budget neutrality rules, in effect in several states, decrease the availability of mental health services and hinder expansion of existing services. Budget neutrality requires the expansion or creation of specialized programs to not increase overall state health care costs. As government dollars become more restricted, publicly subsidized programs like Medicaid, which offer mental health services to the uninsured are compromised. As a result, programs like the Medicaid Early and Periodic Screening, Diagnosis and Treatment (EPSDT), which requires that medically necessary screening be provided to children, could be jeopardized. CHF advocates for the removal of funding caps and the protection of EPSDT laws.
For many families, the consequences of not improving access to mental health services through parity laws, bolstering the workforce, and increasing funding mean resorting to desperate measures to obtain services for their children. Some families may be forced to relinquish custody of their children to state child welfare systems in order for them to access services. CHF believes that it is in the best interest of a child to obtain mental health treatment while having the support systems of their families.
