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WASHINGTON, DC – Nemours Children’s Health and Mental Health America (MHA) have developed a comprehensive slate of federal policy recommendations that, if acted upon, will improve pediatric mental, emotional, and behavioral health. The proposals seek rapid actions to improve current policy regarding the mental health and overall well-being of children in the U.S. in light of the many stressors they face during the COVID-19 pandemic.

Since the pandemic began, mental health-related emergency room visits have increased by nearly 25% for children ages 5-11 and more than 30% for youth ages 12-17. Many more children require immediate and intensive treatments, hospitalization, and longer hospital stays. 

“While the COVID-19 pandemic has exacerbated many long-standing health issues across the nation, it has also provided an opportunity to reimagine our systems of health,” said R. Lawrence Moss, MD, President and CEO of Nemours Children’s Health. “I urge our federal leaders to implement the mental, emotional, and behavioral policy recommendations in this brief. We can create the healthiest generations of children and a nation with greater stability, strength, and prosperity for all.” 

U.S. children have experienced changes in their routines, a disruption in the continuity of their learning and health care, missed peer socialization and life events, and encountered an overall loss of their security and safety. Moreover, the well-being of children has been affected by the intense COVID related stressors on their parents and guardians. Throughout these recommendations, Nemours Children’s and Mental Health America highlight the urgency of intervening quickly, at a time when the detrimental effects of the pandemic may still be fully reversed. 

“The time to act on these policy prescriptions is now,” said Schroeder Stribling, President and CEO of Mental Health America, “Our children and youth cannot afford to wait.”

Even before the pandemic, many children did not receive mental health treatment, including more than 40% of children living with anxiety and 45% of children living with behavior disorders. In addition, there is a particular treatment disparity among BIPOC youth. Of youth who experienced a major depressive episode, 50.3% of white youth reported receiving treatment, compared to just 35.6% of Black youth and 36.8% of Hispanic youth. Children in rural areas are also significantly less likely to receive services than those in urban areas. Furthermore, of children living in poverty who need mental health treatment, less than 15% actually receive services and even fewer complete treatment.

To see the rapid improvements needed for children’s mental health and well-being, Nemours Children’s and MHA recommend that Congress and the Executive Branch undertake the following actions:

  • Expand the children’s mental, emotional, and behavioral health (MEB) workforce. Develop incentives for providers, including child behavioral health professionals and youth/family peer support specialists, such as loan repayment and increased training funding. Place a particular emphasis on professionals serving children who are Black, Indigenous, LGBTQ+, or who live in rural areas. 
  • Ensure access to children’s mental health services in locations accessible to families. Policy options include increased Medicaid reimbursement and integration of mental health care into primary care, schools, and other settings that serve children.
  • Prioritize mental, emotional, and behavioral health promotion, prevention, and early intervention through additional funding for Department of Health and Human Services and Department of Education programs that reach children. To respond to the particular crisis among youth, the Centers for Disease Control and Prevention should create a coordinating center to lead national strategy and programming to reverse the alarming recent trends.
  • Elevate children at the highest levels of federal policy by establishing a White House Office on Children and Youth, a Federal Children’s Cabinet, an Interdepartmental Task Force on Child Well-Being, and a White House Conference on Building Back Better for Children and Youth.
  • Promote innovative Medicaid payment and delivery models to optimize mental, emotional, and behavioral health across the lifespan, including those models that capture long-term value and engage multiple sectors to address key issues (e.g., maternal mental health or kindergarten readiness).

“Over the past eighteen months, Nemours Children Hospital has seen an unprecedented rise in the number of children seeking our care for mental, emotional, and behavioral health concerns,” said Mary Lee, MD, FAAP, Enterprise Chief Scientific Officer and Executive Vice President for Nemours Children’s Health. “We urge federal government leaders to promptly take action on these policy recommendations so our nation’s children can receive the support and services they deserve. The impact of this past year will have long-lasting adverse effects on the health of our children.” 

The brief’s authors note that their recommendations focus on prevention, early intervention, and treatment but do not address other areas of policy that are crucial to children’s mental health and equity, such as intersections with child welfare, juvenile justice, and workforce development.

The full issue brief can be downloaded here.

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About Nemours Children’s Health

Nemours Children’s Health is one of the nation’s largest multistate pediatric health systems, which includes two free-standing children's hospitals and a network of nearly 75 primary and specialty care practices. Nemours seeks to transform the health of children by adopting a holistic health model that utilizes innovative, safe, and high quality care, while also caring for the health of the whole child beyond medicine. Nemours also powers the world’s most-visited website for information on the health of children and teens, Nemours KidsHealth.org.

The Nemours Foundation, established through the legacy and philanthropy of Alfred I. duPont, provides pediatric clinical care, research, education, advocacy, and prevention programs to the children, families and communities it serves. For more information, visit Nemours.org.

About Mental Health America

Mental Health America (MHA) is the nation’s leading community-based nonprofit dedicated to addressing the needs of those living with mental illness and promoting the overall mental health of all. MHA’s work is driven by its commitment to promote mental health as a critical part of overall wellness, including prevention services for all; early identification and intervention for those at risk; integrated care, services, and supports for those who need them; with recovery as the goal. Learn more at MHAnational.org.