The Register Citizen (Torrington, CT)
Taking on the state crisis of mental health care in children
There is no denying the crisis currently happening in our state regarding children’s mental health. Emergency departments around the state are seeing increased numbers of children in distress, waiting for admission for behavioral and mental health issues. Every one of these children are in various stages of crisis, and the longer we wait to find solutions for them, the worse the problem will become.
In late October, as chairs of the Children’s Committee, we held a two-day informational hearing to learn more from professionals about this issue, how widespread it is and how we can find solutions for families in need. The first day, we offered practical help for parents including how to find care, utilizing school resources, managing safety plans at school and home, and even addressed immediate diversions for children who self-harm. The entire video is on CT-N, and individual topics will be released on our Facebook pages for the next few weeks. The second day, we heard from state agencies and experts on their current plans to address the crisis, so that we may develop a plan to fill in the gaps in care.
What we know is there is both immediate and long-term need. Connecticut has numerous services for crisis intervention and entry-level care, but few know what they are, and how and when to use it. Mobile Crisis Intervention, a service available through 2-1-1, allows anyone to call for a mental health assessment, in-person. These are individuals trained in de-escalation and assessment of next needs — the exact place you should call when your child is self-harming, having suicidal thoughts or in any behavioral health crisis.
This resource is wonderful, but underused, as shown by the overflowing emergency rooms. Even as an underused resource, it is still having trouble meeting the demands of the community. While the phone lines are open 24/7, the access is not 24/7. Evenings, nights and weekend coverage needs expansion. An immediate plan of action must include at least $4.5 million of American Rescue Plan Act funding to hire social workers to tend to crises in the overnight hours, as well as make more clinicians available during the day. This one action will save lives, help keep spaces open for the most acute children in the emergency departments, and act as care coordination to the many places for entry-level and higher care available in the state.
Many other mental and behavioral health nonprofit resources are available across Connecticut, but when one talks to parents and even pediatricians, they just aren’t aware of them. In the last legislative session, our committee passed a law to require this information be given to every parent in school twice a year, and to every family who enters the emergency department for any reason, mental health related or not; that goes into effect in January. We must expand this and put that information in the hands of every pediatrician in the state. The state must also do a better job of sharing these resources with families. What good is access to care when parents don’t know it exists?
The second immediate action is aimed at those children who aren’t at the entry level of care, but who also aren’t in need of residential care. These children, adolescents and teens have more complex needs than therapy-only intervention and require medication management. Ask any parent of these kids and they’ll tell you that a psychiatrist who has a specialty in children’s mental health is hard to come by. Often there’s a waiting list, or they don’t take your insurance, if they take insurance at all.
This issue (which we will aim to fix long-term) means more are trying to access meds through their pediatrician, even if the pediatrician feels it is beyond the scope of their training. Therefore, many pediatricians use Access Mental Health, a tele-consult service for pediatricians to work with a psychiatrist to advise them on managing care plans for these kids in crisis. The result is helpful, but we need more. Again, an immediate influx of ARPA funds is required to provide greater staffing for the consultation lines, and to expand the service to include three additional follow-up telehealth services for families whose pediatrician utilized the service. Medication management is a long process, and both parents and pediatricians need help navigating the complexities of med management. We cannot forget that these families are also in crisis, and we must do something to help them immediately. This is a starting point to address immediate needs. We will need to have investments so that all levels of workforce development can be achieved in the entire spectrum of the mental health management of our children.
The longer-term solutions include payment parity for mental health providers, workforce development and retention incentives, requiring insurance companies to incentivize care coordination in pediatricians’ offices, and more. Children’s mental health care positions require difficult work and highly specialized training, yet they do not pay nearly at comparable rates contrasted with other health care roles requiring less stringent requirements. Refocusing how we approach children’s care is an important need; refocusing how we view the professionals caring for them, and ensuring they receive proper restitution, is just as important.
This is a problem not unlike a leaking boat — the biggest hole requires an imminent fix, but without patching the smaller ones, as well, it won’t take long for them to grow and become other weak points. Every day that this goes on, more children are in harm’s way, and some may struggle to recover over time. We are already communicating with our colleagues on how the General Assembly can help improve the situation. The reality is that to have a comprehensive solution to this complex issue, we will need policy adjustment, place more personnel and financial resources, and create efficient systems and make sure the community including all parents are aware of these changes and processes. In our minds, there’s no more important investment of state funds and resources, nor one with bigger dividends then the investment in our children’s mental health and their well-being.
For detailed information on how and where to find help for your child, including a listing of providers by town, visit the Children’s Committee website to download their guide at https://bit.ly/3wHPXEB.
What good is access to care when parents don’t know it exists?
State Sen. Saud Anwar, who represents the Third District, and state Rep. Liz Linehan, who represents the 103rd District, are co-chairs of the Children’s Committee of the Connecticut General Assembly.