Citing advances in addressing children’s behavioral health and areas in desperate need of improvement, a new report suggests the potential for schools and pediatric primary care providers to play a more significant role in addressing a “long-standing crisis “.
The 45-page report, released Thursday by the Massachusetts Association of Health Plans, draws from 25 interviews with anonymous insiders to present insights and recommendations for policymakers to weigh in on this year as the state begins implementation of a health care bill. access to mental health which was signed in August.
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The report calls on Governor Maura Healey’s administration to continue with a roadmap developed under Governor Charlie Baker’s administration that aims to create a “gateway” to the behavioral health care system. That roadmap is designed to make a 24/7 behavioral health helpline available this year, ensure coverage for preventive behavioral health services in primary care settings, grow centers community behavioral health services, increase 24-hour behavioral health and hospital beds, and provide rate increases for behavioral health providers.
The report also recommends changes to bring more order and cohesion to a system criticized for being too disconnected and uncoordinated. It recommends creating a public education campaign regarding the availability of urgent care and crisis services, the development of specialized services for children with high needs, and more coordinated care for children who receive services from multiple agencies.
“Stakeholders universally supported these policies and believed they provided a solid basis for addressing the challenges identified,” according to the report.
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Stakeholders were primarily health plans and assistance providers, but also included Boston and Methuen school officials, state mental health and health and human services officials, and representatives from the Parent/Professional Advocacy League (PPAL), Blue Cross Blue Shield Foundation, and the Massachusetts Mental Health Association.
“It is imperative to look upstream and direct more resources to screening and prevention in primary care and school settings,” said Marcia Fowler, CEO of Bournewood Health Systems and former state mental health commissioner. “Services must be available to children and families in the communities where they live, delivered by professionals representing the Commonwealth’s many diverse communities.”
Mental Health Act enacted this summer requires a state program to assist in the implementation of behavioral health services in every school district and requires each school board to ensure all schools have written emergency health response plans medical and behavioral. He also mandated the State Health Policy Commission to prepare a report on behavioral health planning every three years.
John Crocker, director of mental and behavioral health services for Methuen Public Schools, said ‘It will be essential to look at schools as the prevention arm of the mental health system written in large numbers and the importance of leveraging schools to foster ‘proactive and proactive identification of students with emerging mental health problems and the delivery of evidence-based mental health services and supports for students.’
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Thus, she said, ‘investments in school capacity building will be needed, both systematically to design comprehensive school mental health systems to organize and deliver services effectively, and to support the professional development of mental health staff at the school to provide evidence-based therapeutic care to students.”
Citing numerous sets of statistics, the report chronicles the “alarming” number of young people struggling with behavioral health issues, saying that even before the pandemic, those issues “were the leading cause of disability and poor life outcomes in young people.”
“COVID-19 has made a bad situation even worse,” the report said.
A report by the US Surgeon General in late 2021 said that since the start of the pandemic, 25% of young people surveyed have experienced symptoms of depression and 20% reported feeling anxious – “in both cases, more than double of the pre-pandemic rate”.
In some cases, patients wait weeks and even months for adequate care and may be admitted to emergency departments.
Report says Massachusetts is below the national average for teen suicide and traumatic events known as “adverse childhood experiences,” but above the national average for anxiety, depression, alcohol use, and illicit drug use among children and adolescents . In Massachusetts, nearly 64 percent of children with major depression receive no behavioral health treatment, compared to nearly 60 percent nationwide.
The association plans to present its report Thursday morning and then host a panel discussion during a morning-long virtual forum that will feature remarks from MassHealth’s chief of behavioral health, Emily Bailey.