The Academy and its partners are calling for renewed action from the nation’s leaders to address the pervasive mental health crisis facing young people.
Last October, the AAP, along with the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association, declared a national emergency in child and adolescent mental health. While progress has been made to address the crisis, the state of youth mental health continues to deteriorate and requires immediate attention from policymakers.
On the heels of the declaration’s one-year anniversary, the AAP is leading advocacy efforts to build on the momentum to support the well-being of young people.
As part of this work, the AAP led a letter to President Joe Biden Thursday with more than 130 state and national organizations urging the administration to declare the crisis a federal national emergency.
“There is much more work to do by the Administration and in Congress,” the groups stated. “We urge you to join us in naming the youth mental health crisis exactly what it is — a National Emergency that requires all sectors to come together and take action.”
Year of progress
Over the past year, there have been notable policy victories focused on supporting child and adolescent mental health, many of which were made possible by pediatrician advocacy efforts.
The Bipartisan Safer Communities Act, which was signed into law this past summer, includes key mental health provisions. Importantly, the law reauthorizes the AAP-championed Pediatric Mental Health Care Access program for five years. The program supports primary care pediatricians with telehealth consultation by child mental health provider teams, enhancing their capacity to screen, treat and refer children with mental health concerns. Schools and emergency departments now are able to participate in the programs, and Congress provided an additional $80 million in direct funding for the program.
The Centers for Medicare & Medicaid Services (CMS) also issued two new guidances aimed at increasing access to and payment for mental health services for children through Medicaid’s Early and Periodic Screening, Diagnostic and Treatment benefit and through schools.
CMS urged states to leverage Medicaid and the Children’s Health Insurance Program to provide high-quality behavioral health services to eligible young people. It outlined that these services cannot be denied to those who do not yet have a formal mental health diagnosis, helping to ensure timely access to care. The informational bulletin outlining this guidance reflected direct input from the Academy.
In other guidance, the agency called on states to work with schools to provide onsite health care services to children enrolled in Medicaid, including mental and behavioral health services.
Earlier in the year, AAP President-elect Sandy Chung, M.D., FAAP, testified before a U.S. House of Representatives subcommittee, making her the first primary care clinician to be invited recently by this Congress to testify on the mental health needs of children and adolescents. In her testimony, Dr. Chung referenced the Blueprint for Youth Suicide Prevention, which the AAP released this year with the American Foundation for Suicide Prevention, in collaboration with experts from the National Institute of Mental Health. The document outlines extensive advocacy and policy recommendations to identify and support youths at risk for suicide.
On the state side, the Academy awarded grants to six AAP chapters to advance advocacy projects designed to enhance access to mental health services in their state, address payment barriers, and identify and prevent youth suicide. A second round of funding will be distributed this fall to additional chapters.
This year also brought the implementation of the 988 mental health crisis response line, a first step toward transforming the country’s crisis response approach. States will be working to establish and expand their own mental health crisis response programs.
Call for action
The advocacy achievements from the past year represent crucial progress, but the Academy and its partners are making it clear that the mental health crisis is far from resolved.
“Suicide is increasing for children and teens at alarming rates — especially for Black boys and girls under age 12 — and is now the leading cause of death for Asian American youth and the second leading cause of death for young people nationally,” the groups outlined in their letter to the president.
The AAP has been calling for a whole government approach so that federal agencies with jurisdiction over mental health programs and policies impacting young people prioritize this issue with resources and funding. Particularly, the AAP and its partners are drawing attention to the lack of access to mental health services in historically marginalized communities and the importance of ensuring the continuum of care, from prevention to early identification to treatment. All children should receive “culturally competent, developmentally appropriate, and trauma-informed mental health care without stigma,” the groups stated.
The Academy also is elevating the need to support and bolster the mental health workforce. It is calling for efforts to recruit underrepresented populations and ensure trained pediatric mental health and primary care professionals are paid adequately.
While the provisions in the Bipartisan Safer Communities Act were critical, they represent only the beginning of what is necessary to address the crisis. The AAP continues to urge Congress to advance comprehensive mental health legislation that prioritizes the needs of children and adolescents.
“As pediatricians, we recognize that the current crisis makes promoting mental health a necessity for all children and adolescents. It also requires transformative action to address,” said AAP President Moira A. Szilagyi, M.D., Ph.D., FAAP, in a press release. “By declaring the mental health crisis a national emergency, our federal government can help mobilize resources and activities to address the needs of children and teens.”
