To: Jessica Ramos
From: Mackenzie Godoy
Date: 7/18/2022
Re: Mental Health Crises Among Young Americans
Statement of Issue: Millions of American youth live with a mental health problem. Mental health problems affect 1 in 5 adolescences at any given time, and about two-thirds of all young people with mental health problems are not getting the help they need. Due to the lack of early screening and intervention, many of young Americans go on to carry these mental health issues into their adult life causing them to lead dysfunctional lives. Some people develop substance abuse issues, some struggle with suicidal thoughts and self-mutilation, and others display behavioral issues within school that ultimately leads to dropping out, suspension or being integrated into the juvenile disciplinary system.
- There are many young Americans who struggle with mental health, and they are at risk of committing suicide. The suicide rate in the U.S. is the highest among wealthy nations, and data suggest that 1 in 5 young women (and 1 in 10 young men) experience a clinical episode of major depression before age 25 (Prinstein, 2022).
- Suicide rates are on the rise. Suicide rates among children 10 and older have climbed significantly since 2007, now the second leading cause of death among 10- to 24-year-olds, behind unintentional injuries (Prinstein, 2022).
- A large percentage of American youth who deal with mental health disorders also experience behavioral problems, and sometimes end up in the juvenile disciplinary system. A meta-analysis by Vincent and colleagues (2008) suggested that at some juvenile justice contact points, as many as 70 percent of youths have a diagnosable mental health problem.
- Early screening & intervention in schools can aid in preventing adolescents from leading dysfunctional lives. One study indicates that “SBMHS [school-based mental health services] increased prosocial behavior, appropriate classroom behavior, and academic achievement of participating students” (Kern et al., 2017).
- Mental health disorders develop early on in life. “With respect to prevalence, it has been estimated that 46.3% of school-aged youth between the ages of 13 and 18 have experienced a mental illness at some point in their lives and slightly more than 20% have been diagnosed with a seriously debilitating mental disorder” (Forness, Kim, & Walker, 2012; Merikangas et al., 2010; as cited in Kern et al., 2017).
Policy Options
- Support H.R. 1211 – 114th Congress: Mental Health in Schools Act of 2015. This proposed bill seeks to extend mental health services to children by providing access to school-based comprehensive mental services. Additionally, the act seeks to revise, expand, and increase funding for the Safe Schools-Healthy Students program to be able to provide access to more comprehensive school-based mental health services. It would also provide comprehensive staff development for those involved or working in schools, and training for children with mental disorders, family members affected, and concerned community members.
- Advantages: This bill would reduce issues of cost, transportation, and accessibility that commonly prevents access to mental health services. Students also spend most of their day at school, so having access to school-based mental health services would provide support for mental health services while maintaining educational goals for students and collaboratively working with parents and community providers (Weist & Evans, 2005, as cited in Kern et al., 2017). It also addresses a diverse population.
- Disadvantages: Access to mental health services at school can open doors to bullying (Ttofi et al., 2011, as cited in Kern et al., 2017). While care is confidential, there is no guarantee that students will not notice who is seeking and receiving mental health services. With stigmas concerning mental health, young people may be less reluctant to seek care to avoid becoming targets of bullying.
- Support H.R. 7076 – Supporting Children’s Mental Health Care Access Act of 2022. This bill would reauthorize the Pediatric Mental Health Care Access Program at the Health Resources and Services Administration. The act supports pediatric primary care practices with telehealth consultation by child mental health teams, thereby increasing access to mental health services for children and enhancing the capacity of pediatric primary care to screen, treat, and refer children with mental health concerns.
- Advantages: This bill would increase the likelihood of young people to seek out care for mental health concerns, while also avoiding the possibility of being bullied; it creates a more private approach. It also expands access to mental health care and improves health and functional outcomes.
- Disadvantages: There may be some children or adolescents may not have access to a computer in the privacy of their home to conduct a telehealth visit. Others may not have insurance if they are illegal residents of the U.S.; therefore, some parents may be reluctant to have their child partake in telehealth visits even if they did have insurance.
- Provide incentives to ensure more children can access services through Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. EPSDT provides children with protections to ensure early identification and medically necessary treatment for those with or at risk of mental health conditions. However, only about 60% of children actually receive those services, which indicates the need for providers to complete screenings (National Alliance on Mental Health, 2022).
- Advantages: More children will receive the care they so desperately need allowing for early identification and treatment.
- Disadvantages: There are some states who have not expanded Medicaid making certain older, low-income adolescents ineligible for coverage. It would not resolve the issue of lack of early screening and intervention for all children or adolescents.
Policy Recommendation: The U.S. faces a major mental health crisis among young Americans, and steps must be taken to address the issue. While there are some practices set in place, such as Medicaid’s EPSDT, intervention is often provided too late. The goal should be to prevent children and adolescents from reaching a point in their lives where a mental health disorder has caused social or functional impairment; therefore, it is more conducive to provide mental health services that focus on early screening and intervention like comprehensive school-based mental health services. Comprehensive school-based mental health services would increase access to mental health services while also maintaining educational goals. As far as bullying is concerned, measures could be taken to increase confidentiality of the mental health visits at school to avoid becoming a target of bullying. It would also help to create an environment that fosters positive attitudes towards mental health services which could change negative views about seeking mental health support.
References
Forness, S. R., Kim, J., & Walker, H. M. (2012b). Prevalence of students with EBD: Impact on general education. Beyond Behavior, 21(2), 3–10.
Home: Nami: National Alliance on Mental Illness. NAMI. (2022, February 8). Retrieved July 18, 2022, from https://www.nami.org/Home
H.R. 1211 (114th): Mental Health In Schools Act of 2015. GovTrack.us. (2015, March 3). Retrieved July 18, 2022, from https://www.govtrack.us/congress/bills/114/hr1211/text
Kern, L., Mathur, S.R., Albrecht, S.F. et al. The Need for School-Based Mental Health Services
and Recommendations for Implementation. School Mental Health 9, 205–217 (2017). https://doi.org/10.1007/s12310-017-9216-5
Merikangas, K. R., He, J. P., Brody, D., Fisher, P. W., Bourdon, K., & Koretz, D. S. (2010).
Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics, 125, 75–81. doi:10.1542/peds.2008-2598.
Model Programs Guide Literature Review: Intersection between mental health and the Juvenile
Justice System. Office of Juvenile Justice and Delinquency Prevention. (2017, July). Retrieved July 18, 2022, from https://ojjdp.ojp.gov/library/publications/model-programs-guide-literature-review-intersection-between-mental-health-and
Position statement 41: Early identification of mental health issues in young people. Mental
Health America. (n.d.). Retrieved June 15, 2022, from https://mhanational.org/issues/position-statement-41-early-identification-mental-health-issues-young-people
Prinstein, M. J. (2022, January 28). US youth are in a mental health crisis-we must invest in their
care. American Psychological Association. Retrieved July 18, 2022, from https://www.apa.org/news/press/op-eds/youth-mental-health-crisis
Ttofi, M. M., Farrington, D. P., Losel, F., & Loeber, R. (2011). Do the victims of school bullies tend to become depressed later in life? A systematic review and meta-analysis of longitudinal studies. Journal of Aggression, Conflict and Peace Research, 3, 63–73. doi:10.1108/17596591111132873.
Vincent, G. M., Thomas Grisso, Anna Terry, and Steven M. Banks. 2008. Sex and Race
Mental Health Symptoms in Juvenile Justice: The MAYSI-2 National Meta-Analysis. Journal of the American Academy of Child and Adolescent Psychiatry 47(3):282–90. https://doi.org/10/1097/chi.0b013e318160d516
Weist, M. D., & Evans, S. W. (2005). Expanded school mental health: Challenges and opportunities in an emerging field. Journal of Youth and Adolescence, 34, 3–6. doi:10.1007/s10964-005- 1330-2.
