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Children’s Mental Health: Current Challenges and a Future Direction

Children’s Mental Health: Current Challenges and a Future Direction. Sarah Olbrich MPH Candidate, George Washington University The Center for Health and Health Care in Schools June 7, 2002. Objectives. Background on Children’s Mental Health Statistics Disorders

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Children’s Mental Health: Current Challenges and a Future Direction

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  1. Children’s Mental Health:Current Challenges and a Future Direction Sarah Olbrich MPH Candidate, George Washington University The Center for Health and Health Care in Schools June 7, 2002

  2. Objectives • Background on Children’s Mental Health • Statistics • Disorders • Traditional service provision • A New Approach to Children’s Mental Health Services: School-Based Health Centers (SBHC) • Types of services provided • Types of mental health services and providers • Why SBHC-sponsored mental health services are a gold standard • Opportunities and Challenges

  3. Statistics • 20% of children ages 9-17 have a diagnosable mental, emotional, or behavioral disorder (1) • 70% of children with a diagnosable disorder do not receive mental health services (2) • Minority populations are less likely to have access to mental health services (1,2) • Greater than 50% of low-income children are at risk for a mental health problem (3) 1) US DHHS. Executive Summary. Mental Health: A Report of the Surgeon General. 1999 2) RAND. Health Research Highlights: Mental Health Care for Youth. 2001 3) Adelman H., Taylor L. Guidebook: Mental Health and School-Based Health Centers. The School Mental Health Project. The Center for Mental Health in Schools

  4. The Prevalence of Common Mental Health Disorders Affecting Children and Youth CMHS. Mental, emotional, and behavior disorders in children and adolescents. The Center for Mental Health Services. Accessed at www.mentalhealth.org/publications/allpubs/CA-0006/default.asp

  5. Current Mental Health Services • There are four sectors in which children in need of mental health services can receive care: • the specialty mental health sector • the general medical/primary care sector • the human services sector • the voluntary support network sector

  6. Limits of Current Mental Health Service Arrangements • Do not meet the need • Mental health system capacity • Provider Shortage • Insurance Coverage • Schools have become the de facto source of mental health services for children

  7. Schools as Mental Health Service Providers

  8. School-Based Health Centers • 1500 SBHC nationally • Provides primary care, intervention, and mental health services • Can provide comprehensive mental health services • Decreased stigma associated with mental health services • 60% of SBHCs have mental health professionals on staff • 80% of SBHCs provide crisis intervention services

  9. Mental Health Services and Providers in SBHCs • Services • Assessment • Counseling (group & individual) • Intervention • Providers • Clinical Social Worker (36%) • Mental Health Unspecified (18%) • Psychologist (12%) • Substance Abuse Counselor (8%) • Psychiatrist (4%) Source: Census of the National Assembly on School-Based Health Care, NASBHC, Washington, DC 2000

  10. Strengths and Weaknesses to Mental Health Care Via SBHC • Strengths • Accessibility • Decreased Stigma • Weaknesses • Provider Shortage Remains • Funding Problems Remain • Dependent on School Collaboration

  11. Funding Issues • SBHC • Grants (Federal, State, Local, Private) • 3rd Party Reimbursement • In-Kind Contributions from Community • SBHC Mental Health • Grant • 3rd Party • Parity Issues

  12. State Policy Support for Reimbursing SBHC • SBHC are eligible for Medicaid reimbursement in 36 states • SBHC are eligible for SCHIP reimbursement in 30 states • SBHC contract with Medicaid managed care in 17 states

  13. SBHC Mental Health Services • Reasons for Optimism • Strong State Support • Increased Public Awareness of Children’s Mental Health • Columbine Shootings • Effects of WTC Attack on NY City School Children • Reasons for Concern • Complexity of Funding • On-going Provider Shortage

  14. The Future of Mental Health and SBHC • SBHC are increasing the number of mental health providers and services in schools • Decreased numbers of children with unmet mental health needs • Reaching goals of Healthy People 2010

  15. For More Information • The Center for Health and Health Care in Schools www.healthinschools.org • Center for Mental Health Serviceshttp://www.mentalhealth.org/cmhs/ • Mental Health: The Surgeon General's Report http://www.surgeongeneral.gov/library/mentalhealth/toc.html#chapter3 • National Institute of Mental Health http://www.nimh.nih.gov • University of Maryland Center for School Mental Health Assistance http://csmha.umaryland.edu/ • School Mental Health Projecthttp://smhp.psych.ucla.edu

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