Legislators hope to make mental health top priority
With more kids seeking help, it will be ‘major focus’ in upcoming session
With the pandemic taking a massive toll on children’s mental health, Connecticut lawmakers are already beginning to plan what reforms may best target a longtime crisis.
Over the last several weeks, legislators have hosted forums with behavioral health professionals, state agencies and child experts to discuss what is happening and where improvements need to be made in the state.
Connecticut emergency departments saw an overwhelming number of children seek psychiatric care as the toll of the pandemic fell on the state’s youngest residents last year and as students headed back to in-person classes this school year.
Legislative leaders say mental health services will be one of the substantive issues during the 2022 session, which begins in February. Next year’s session is only three months, however, and lawmakers will have to move quickly to get important bills through the General Assembly.
“I think you’re going to see it be a major focus,” said House Speaker Matthew Ritter, D-hartford, who recently convened a forum on the issue. “It’s a problem. It was a problem before COVID, and obviously, things got exacerbated since then.”
Hiring more people
Some of the legislative efforts this session may focus on funding — directing more money toward staffing and incentives to work in the mental health industry.
“There are a real lack of people in that space. So that’s something we have to think about — how do you incentivize people to move to Connecticut and practice in that space?” said Ritter. “That’s probably a combination of loans or one-time payments. It’s like recruiting; you have to recruit people to come to Connecticut to do this.”
Lawmakers are also exploring whether to use out-of-state providers. Some providers in the mental health field must be licensed in Connecticut to practice here. Legislators are considering waiving certain licensure requirements to enable providers from Massachusetts, New York or other states to conduct telemedicine appointments with Connecticut residents.
The co-chairs of the Children’s Committee, Rep. Liz Linehan, D-cheshire, and Sen. Saud Anwar, D-south Windsor, said workforce development is also one of the top priorities heading into the
2022 session.
They are considering legislation that would increase the number of training programs for social workers and psychiatrists, looking at intermediate and long-term plans to ensure psychiatrists are paid fairly and considering how to improve reimbursement rates.
Linehan wants to build on a bill introduced in 2021 that would provide tax incentives to psychiatrists to buy a house in Connecticut by including doctors and nurse practitioners who “have prescribing abilities in the mental health field all around the country.”
The program’s incentives would include a rebate on the income taxes they pay while working in Connecticut and a grant from the state for a down payment to buy a home if they stay in the state for 10 years after graduating medical school.
Helping pediatricians
Linehan and Anwar have also had conversations about other legislation that could enhance mental health care coordination at pediatrician offices.
“So another thing that I really think is going to be hugely important and that we can scale up very quickly … is to beef up our access mental health program,” she added.
Access Mental Health is a referral program pediatricians can use if they are presented with a child showing mental health symptoms that they do not feel they have the specialty to handle. The pediatrician can then call Access Mental Health to speak to a psychiatrist and get a referral for that child.
Linehan’s top priority is to strengthen Access Mental Health by budgeting for an “immediate infusion of funds” to help double the number of psychiatrists on call for the program.
“The family can receive three telehealth visits with that psychiatrist if they desire and be covered by insurance and, if not, at least for the time being until we’re out of this pandemic, hopefully the state can cover those three telehealth visits for each family,” Linehan said.
Working with schools
For the 2022 session, legislators are also exploring funneling more resources to schools.
“It’s not just [health care] facilities. Everyone thinks we just need to add beds. But as you peel back the layers, it’s much more complicated than that,” Ritter said. “It’s the workforce, and it’s also trying to keep people from those beds. It’s so much more expensive. And so that might be hiring people and subsidizing school districts to have more counselors and providers on hand, so situations don’t escalate.”
Resources for children in schools and the community is a key area of focus. While some children will need institutionalized care, others are trying to access resources at home without success.
“There are going to be kids who need beds and who need [institutional] treatment. But a lot of these
cases can be handled without that step,” Ritter said. “Take a family where both parents have the resources — they can watch the kid around the clock. Sometimes they’re being told it’s going to be weeks until they can see a counselor. And that’s when it escalates into the emergency room.
“Our emergency room has become the de facto, in some cases, mental health counseling for people. And we need to find a way to say to that parent, ‘We’re not going to have a two-week waiting list [for a counselor].’ But that’s not going to be easy to fix.”
With Connecticut having funding linked to the schools based on trauma, the state can strengthen its ability to manage some of these challenges, Anwar said, but that coordination between the schools and mobile crisis is going to be critical in making that happen.
He said there is an urgent need for a $4.5 million boost to mobile crisis.
Currently, phone services run 24 hours a day, seven days a week, but there is no crisis intervention mobile service available on weekends or at night.
“So we need to actually have that available, because if we don’t have that, those same children will go to the emergency room,
whereas they’re not going to necessarily get the help in a timely fashion that they’re hoping to,” Anwar said. “So if we do it … with a mobile crisis intervention that we are looking at, that will help us out.”
Linehan also plans to craft legislation focused on the children who may have missed their opportunity for entry-level behavioral health care or “those mid-level kids who are maybe in need of medication, who may be in need of an intensive outpatient program or a partial hospitalization program,” she said.
Linehan and Anwar said many of their colleagues are on board and want solutions that are swift but will address the problems long-term.
“If we do not have a comprehensive strategy, we will be back here having the same conversation again. So I think no more Band-aids,” Anwar said. “Let’s fix this and take care of this. Because investment efforts, coordination, is going to save lives, and they’re going to save the lives of our children, and the lives of our children are worth it for us to put all hands in and do it together in a manner that the experts have asked us to do, in a manner that really shows that it works.”