Improving Quality and Coordination of Child and Adolescent Mental Health Services

Background

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 children, adolescents, and their families as well as schools, communities, employers, and the nation as a whole.

Talking Points

In order to promote mental health for children and adolescents, to identify problems early, and intervene early when efforts are most likely to be successful, a comprehensive national mental health care policy for children and adolescents in America, with a supporting infrastructure, must be established:

  • Develop family-centered and culturally appropriate treatments in those areas where knowledge gaps remain for child and adolescent mental health problems.

  • Support resources for the training and research needed to transfer successful prevention and treatment programs from research clinics to community clinics and to evaluate their effectiveness in those settings.

  • Develop a system with built-in incentives for providers to deliver high quality care. Encourage additional provider training.

  • Develop a primary mental health care system to fully address problems with the quality of child and adolescent mental health care in America, including reimbursement of primary care professionals for early intervention and prevention services that promote mental health and prevent or treat mental disorder. A private-public partnership will be necessary.

  • Support basic research in child development and neuroscience into the effects of the family, culture, and environment on prevention and treatment outcome.

  • Address the poor coordination, inconsistent policies, and inadequate funding that result in children with unidentified and unmet mental health needs in preschools, elementary and high schools, special education, foster care, child welfare agencies, medical centers, and juvenile justice systems across the US. Often children are involved in several of these systems simultaneously without any single agency assuming responsibility for their care.

  • Direct effort and resources towards monitoring and evaluating the services provided to families in the community. Develop a system to judge progress, effectiveness of interventions, and improvement in the quality of care to families in need.

  • Develop policies that promote integration, coordination and accountability of agencies and services, and provide sufficient resources for research, training, and reimbursement for high quality care.