Current data shows that 1 in 5 children in the United States suffers from a diagnosable mental health disorder, but only 21% of affected children actually receive the treatment that they need. Mental illness health outcomes are better when conditions are identified and treated early. However several barriers stand in the way of children and adolescents receiving the best mental healthcare possible. Two ways to improve access to mental health treatment for children are to support funds for providers to receive education to enter mental health professions and to endorse comprehensive coverage for Medicaid patients.
In light of many recent highly publicized tragic incidents such as the Sandy Hook school shooting, it is becoming more apparent that mental illness is present and not uncommon in our youth. However, the current number of pediatricians specializing in behavioral and mental health is insufficient to best meet the needs of the population. According to a 2012 survey conducted by the Children’s Hospital Association, the average time for a family to see a developmental pediatric specialist is 14.5 weeks; 8.9 weeks for neurology and 7.5 weeks for child and adolescent psychiatry. Fewer individuals are choosing careers in pediatric subspecialties and pediatric mental health care. Financial concerns, such as debt load and poor Medicaid reimbursement, are listed among the top deterrents.
A federal bill H.R. 1827: Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013, was introduced to the House of Representatives on May 6, 2013. It has been assigned to and stalled in the House Committee on Energy and Commerce: Health. The bill would help increase the workforce in pediatric behavioral and mental health specialists. It would reauthorize through 2018 a pediatric specialty educational loan repayment program for health professionals providing pediatric medical subspecialty, pediatric surgical specialty, or child and adolescent mental and behavioral health care in an area with a shortage of the specified pediatric subspecialty that has a sufficient pediatric population to support the subspecialty. Write to your federal legislators urging them to help move this bill forward.
In addition, Medicaid and private insurance policies alike have mental health carve outs that prevent many primary care physicians such as general pediatricians from being compensated appropriately for early diagnosis and intervention for common mental health conditions such as ADHD, depression, and anxiety. They also don’t provide compensation for identification of emerging behavioral symptoms that don’t meet criteria for a diagnosis.
The AAP has suggested changes to Medicaid that would enhance the ability of primary pediatricians to provide mental health services, support co-location of mental health professionals in pediatric practices, and to integrate mental health into community primary care.
Then let your voice be heard by petitioning your federal legislators to address the issue of enhancing pediatric mental health benefits in Medicaid.
Untreated mental health disorders lead to higher rates of juvenile incarcerations, school dropout, family dysfunction, drug abuse, and unemployment. Children are our future, so let’s make a difference for the future of our nation!
by Brittney Pryor, MD