Mental health resources for children lacking, but legislation seeks to improve access

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At the primary care office of Children’s Hospital of Philadelphia in Doylestown, Dr. Naline Lai has seen children so anxious they can’t eat or have trouble going to school. A mother told her she called 20 therapists before she found one to see her daughter, but the first appointment she was able to get was a month later.

Every day, 20 to 30 children with mental health issues wait in hospital beds because there aren’t enough regional facilities in the Delaware Valley and across the country to care for them all. children who need care, said Dr. Joseph W. St. Geme, CHOP’s chief medical officer.

“Often, when services are finally identified, they are away from the family or the child’s support system, which creates additional stressors,” St. Geme said. And every hospital bed a child occupies while awaiting psychiatric care is “no longer available for its intended use”.

The two doctors and other CHOP officials, including chief psychiatrist Tami Benton, drew attention to the issue of care for children in crisis and the lack of resources for them at a press conference in Doylestown on Tuesday. . They called for change and touted several bills in Congress that they believe will address the critical nationwide shortage of services for children and youth with mental health needs. Brigid Garvin, a psychologist at St. Christopher’s Hospital for Children, also joined the conference.

Benton said there are about 15 million children in need of mental health services nationwide and only 8,000 to 9,000 youth psychiatrists.

“There is currently a severe shortage of child mental health professionals in our country,” she said, citing that 80% of counties do not have a licensed child psychiatrist. She said disenfranchised children, especially minorities, have less access to mental health care but are more likely to be exposed to violence and trauma.

The COVID crisis has not helped the situation, she added.

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But the shortage does not only affect children living in the poorest urban or rural areas. Lai, who runs the CHOP site in Doylestown, said up to 50% of visits to the pediatrician involve a mental health component.

“With the severe shortage of pediatric mental health providers, we general pediatricians have had to help fill that gap. Many have sought additional training,” she said, in her own time and at her own expense.

When patients are referred to separate psychological services, only about a quarter to half show up for a mental health appointment. But when CHOP launched a “Healthy Mind, Healthy Kids” program to integrate mental health care into regular pediatric services, attendance “greatly improved,” she said. That’s why she said the bills that U.S. Representative Brian Fitzpatrick, R-1, of Middletown, Bucks County, is co-sponsoring to increase federal support for pediatric mental health care integrated with other medical services are so important.

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Invoices include:

The Children’s Mental Health Infrastructure Act (House Resolution 4943) which would provide funding to children’s hospitals for additional pediatric care capacity for behavioral and mental health services.

The Helping Kids Cope ACT (HR 4944), which would “provide funding to support the integration and coordination of pediatric behavioral health care” with other health care services.

The Strengthen Kids’ Mental Health Now Act (HR 7236) would “strengthen the pediatric mental health workforce” and ensure that children receive a “full continuum of care.”

Fitzpatrick said he was working with Rep. Anna Eshoo, a Democrat from California, on HR 7236 and Rep. Blunt Rochester, a Democrat from Delaware who introduced HRs 4943 and 4944, to build bipartisan support for the bills. law. They hope to get 290 co-sponsors per bill so that bills can bypass House leadership and come straight to the floor for votes before the session of Congress expires in January 2023.

Fitzpatrick said mental illness must have the same parity as other illnesses or medical conditions when it comes to treatment options and insurance coverage, and like physical education, there must be health education. mind in schools. He said schools should also have both a school nurse and a school psychologist.

“For a long time, certainly my whole life, our country has treated neck disease very differently than we treat neck disease… Mental health issues (are) stigmatized… If you have a disease emotional or psychologically tragic incident, and seeking treatment for that is viewed very differently,” he told the conference. “I can’t think of a better investment we could make in our country than to create health parity at all levels from a health insurance perspective…Full parity at all levels is the way to end the stigma.”

Fitzpatrick continued that mental health issues are “a root cause of so many other challenges we face in our country,” including substance abuse and gun violence. “We owe it to our children… We have no higher calling as churchgoers, as elect, as human beings than to take care of our children. It is the highest calling we all have.”

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Benton said CHOP will open its new Center for Advanced Behavioral Health, a 47,000 square foot facility with 64 offices and consulting rooms, this week in Philadelphia. Next spring, it plans to open an inpatient behavioral facility for pediatric acute care with 56 beds, including 10 for crisis care at the Public Health Management Corp. (PHMC) campus on Cedar Avenue in West Philadelphia. The campus is the former Mercy Catholic Medical Center which is now operated by PHMC with Penn Medicine and CHOP overseeing the facility.

John Grove, a behavioral health clinician with CHOP’s Healthy Minds program, said fundamental legislative reforms are “essential, absolutely essential. We must not wait until our children are in crisis before we meet their needs and help them… It’s time to pivot the system towards preventive care Preventive care has tremendous benefits.

He said 50-75% of young people in juvenile detention facilities have underlying mental health issues. “Preventive care to prevent low acuity problems prevents high acuity problems. It saves lives.”

Garvin thanked Fitzpatrick for supporting all three bills, saying she would echo comments from CHOP doctors about the need for more psychological care for children and adolescents, changes in insurance reimbursement and more education on mental health care for paediatricians.

CHOP officials also said they were grateful to the congressman for his leadership.

“Obviously, our children are in crisis and when our children are in crisis, our nation is in crisis,” St. Geme said. But with the legislation before Congress, “there is cause for optimism,” he said.

Fitzpatrick said Pennsylvania Senator Bob Casey also leads legislation in the Senate, saying the Commonwealth has long had a prominent role in health care history and legislation. According to Casey’s website, he and Republican Senator Bill Cassidy of Louisiana introduced a health care capacity bill for pediatric mental health in the Senate in June that would provide grants to help health care providers. expand mental health services for young people.

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