In many ways, human life, and childhood specifically, have grown easier over generations. We’ve virtually eliminated some childhood diseases, outlawed stuffing small children into factory work, and generally made a lot of things safer and more accessible.
At the same time, there are many new stressors for kids, and some longstanding ones are manifesting in new ways. Peer pressure and bullying are now online, so they can follow our kids home; our kids now sit through active shooter drills at their schools; a pandemic recently robbed many of them of loved ones; and in general, our kids are witnessing things in the news, politics, economy, and social lives that just leave them anxious and overwhelmed.
One In Five Households Reports A Need
A study published in the Journal of the American Medical Association (JAMA) examined data from the U.S. Census, learning that there has been a 35% increase in diagnosed mental health conditions in children since 2016, with about 1 in 5 households reporting that one or more children in the home needed mental health treatment.
At the same time, a significant number of households are reporting that they have a child who needs mental health support and isn’t getting it.
“Furthermore, almost 40% of children aged 12 to 17 years with a major depressive episode did not receive treatment in the past year. Reported barriers include financial costs, limited clinician availability, and logistical challenges”
All told, about a quarter of kids who needed mental health care did not receive it, according to News-Medical.
The Gap Is Wider For Some Children
Lead author of the study and project manager at the Harvard Pilgrim Health Care Institute, Alyssa Burnett, noted that certain demographics of children were less likely to receive the needed care.
“It is concerning to see larger gaps for single-parent and multi-child households, households with homeschooled children, uninsured households, and households with Medicaid.”
Medicaid and CHIP Payment and Access Commission (MACPAC), a federal agency that researches and advises on Medicaid policy, reported in 2019 that only around a third (35%) of psychiatrists would accept new Medicaid patients of any age. Combine that with CDC data showing that there’s a desperate shortage of child psychiatrists, and there’s a clear picture of a world where kids relying on Medicaid will have long waits to access a psychiatrist who will accept it.
Rural Areas Are Heavily Affected
According to the CDC, a majority (61%) of the areas with mental health care shortages are rural. Furthermore, these areas often lack infrastructure and internet providers with a signal that is sufficient for telehealth.
That means if they can find a provider who will accept their insurance and has an opening, it will likely mean missed school for the kid, missed work for a parent, and working out the logistics of childcare for siblings. For some families, this sets the bar at impossible; for others, while it may be possible, it requires enough support and organization that it may not happen.
The CDC also cites higher poverty rates and lack of transportation in these rural areas as additional barriers to accessing care. Even if they can find a provider within a few hours’ drive who will accept a new Medicaid patient, a parent may not be able to sacrifice a day of income and pour cash into the gas tank to make that trip very frequently.
Add in that stressors in the child’s life may be affecting the whole family. Finances, a parent’s job loss, or deaths in the family may mean that parents are also juggling their own mental load while trying to keep the family afloat. It’s yet one more factor that can make accessing mental health care even more difficult.
What Can We Do About It (Collectively)?
The American Academy of Child & Adolescent Psychiatry (AACAP) has released a statement with policy recommendations that they believe would help fill these gaps.
They recommend loan-forgiveness programs for those who enter child-serving mental health work to reduce barriers for those who want to enter the field, and they’d like policies that encourage medical students and mental health trainees to consider working with kids.
They’d also like to offer programming to increase the mental health training of other child-centered healthcare workers. In other words, your child’s pediatrician could help with some basic mental health care, especially in areas where access to mental health services might be limited.
In fact, another of their policy recommendations is to help community members, including teachers, clergy, family members, and other caregivers, better understand mental health, so they’re better prepared to provide support.
What Can Parents Do, Personally?
Be an advocate for your children, and teach your children (at age- and maturity-appropriate levels) to advocate for themselves.
If telehealth services are restricted due to internet access, keep asking questions. Can your child use a private room at school or the library and use their internet to join a telehealth appointment? Are there traveling or mobile crisis programs to fill gaps between appointments? Does your state’s Medicaid program have travel vouchers, even if you have to ask for them?
Be there for your child and keep listening, and keep seeking resources. Show them support, and if your own mental health is in need, set an example by letting them see you work on it.
Let your elected representatives know you see a problem, and encourage them to make policy decisions that could improve matters.