Kids are in mental health crisis; we need to act now

Our children are not okay.

The pandemic highlighted a childhood mental health crisis that has led national organizations to call for an emergency declaration and led the U.S. Surgeon General to issue an advisory citing alarming increases in youth mental health challenges.

In February, the U.S. House Ways and Means Committee held a special hearing on “America’s Mental Health Crisis,” where I had the honor to provide testimony on its impact on children and the workforce.

Recently, Gov. Mike Dewine called for more community–based mental health services in his State of the State address.

How do we know kids are not OK?

Also in February, Public Children Services Association of Ohio released a survey of representative county children services agencies showing that nearly 1 in 4 (24%) kids who came into custody last year did so primarily due to significant mental health needs, developmental/intellectual disabilities or as a diversion from juvenile corrections.

Finding appropriate and available placements for these youth has led to a crisis impacting county children services agencies across Ohio.

These kids entered foster care last year, not primarily because of abuse or neglect but because children services has become the system of last resort.

Ohio needs more community-based alternatives that could better serve youth at home, as Dewine touched on in his speech.

Hospitals lack the capacity to meet their acute needs and provide mental health crisis stabilization.

Ohio lacks foster families trained and willing to take youth with challenging behaviors.

Unfortunately, the only option for many of these youths is a mental health treatment facility. These facilities are struggling with workforce challenges, including reduced capacity or lack of staff trained to manage complex behaviors.

How have workers been impacted?

Our workforce is not okay either. Public Children Services Association of Ohio, in conjunction with the Ohio State University College of Social Work, released a workforce study this year. Turnover is rampant in county agencies, increasing caseloads to unsustainable levels. Staff frequently contact 50 to 100 provider agencies before securing a foster home or residential facility placement for these youth.

With limited options, agencies too often make the desperate decision to send youth out of state for treatment or have the child spend one or more nights at the county agency.

A county in northeast Ohio recently had three staff members resign because of the demands of being unable to find the placements and services youth need. This placement crisis is adding stress and trauma to an already overburdened workforce.

Will things improve?

Hope is on the horizon. Dewine has prioritized improving lives for Ohio’s children, particularly those in foster care. State funding for multi-system youth has helped. OHIORISE, a new Medicaid managed care program, will coordinate the complex care these youth require when it launches later this year. Agencies have new technology to seek and engage kin. Intensive home-based treatment and crisis services to help struggling families are expanding.

But until these efforts are fully operational, the child protection system is treading water—and so are the kids we serve.

That is why we need a call to action. We must come together at the state and local level with a sense of urgency and a clear timeline to develop and implement a comprehensive rapid-response approach for youth with highacuity needs. These are our children.

They are waiting, and they are counting on us.

Angela Sausser is executive director of the Public Children Services Association of Ohio. Previously, she served as chief of the Bureau of Children and Families for the Ohio Department of Mental Health and Addiction Services and as director of Ohio Family and Children First Cabinet Council.