Improving the Financing Infrastructure

Child and adolescent mental health problems are at a point of crisis for our nation. One out of every ten children or adolescents has a serious mental health problem, and another 10% have mild to moderate problems. Mental health problems in young people can lead to tragic consequences, including suicide, substance abuse, inability to live independently, involvement with the correctional system, failure to complete high school, lack of vocational success, and health problems.

There is a lack of mental health services for children and adolescents. Less than half of children with mental health problems get treatment, services, or support. Only one in five gets treatment from a mental health worker with special training to work with children. Families that are poor, are people of color, or have children with other disabilities or health concerns have an especially difficult time getting services that would identify, prevent or treat mental health problems.  Children and adolescents with mental health problems are usually involved with more than one agency or service system, including mental health, special education, child welfare, juvenile justice, substance abuse, and health. However, no agency or system usually takes responsibility for coordinating their care or prevents them from falling through the cracks and not getting needed services.

The costs of mental health problems in children are great for our country. They affect the children, adolescents and their families, as well as schools, communities, employers and the nation as a whole.

There is not adequate financial support for quality services for preventing and treating mental health problems of children and adolescents. Many child mental health services are not covered by managed care payers:

• Government agencies and private insurance companies should change payment policies related to children's mental health to support a full range of services, including home and community based services, as well as supports that are well coordinated, and sensitive to a family's needs, cultural differences, and what is appropriate for children at different ages. Payment policies for mental health services should be the same as those for physical health problems. Mental health care costs need to included in coverage policies for children's overall healthcare.

• Federal, state, and local governments should ensure that families, substitute families, and other caregivers, are full partners and involved in all aspects of service planning and decision making for their children.

• A national effort focusing on the mental health needs of young children and their families should be implemented. Because environmental factors can shape brain development later behavior, this effort should include educating parents, the public and professionals about the importance of the first year of a child's life for developing a base for healthy social and emotional development.