Tag: Behavioral Health

Teen Health Crisis

Adolescent Mental Health & Wellbeing

A new CDC report points to record levels of violence, trauma, and mental health concerns for teenagers, with girls and LGBQ+ youth faring more poorly (the survey did not ask about transgender identity). The findings highlight how the pandemic made things worse for many kids.

  • Violence: Violence puts adolescent lives at risk and can lead to mental health problems, risky behavior, and reduced academic success. The CDC report contains data on violence among high schoolers, including sexual violence, feeling unsafe at school, bullying, and cyberbullying.
  • Technology: High use of social media is associated with mental health problems. Social media impacts how teens interact with one another during a developmentally important time in life. According to new research, limiting social media usage can make teens feel better about their body image.
  • Supporting Mental Health: Young people who identify as LGBTQ+ are less likely to feel depressed with parental support. Additionally, public schools and states are taking steps to expand access to mental health services.

Read more at NIHCM.

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Suicide Among People with Disabilities

We may make assumptions about people with disabilities’ risk for suicide. A 2021 report published in the American Journal of Preventive Medicine found people with disabilities are more likely to think about, plan or attempt suicide than people without disabilities.

Please click the link below to learn more about:

  • Risk factors.
  • What you can do as a caregiver.
  • What to look for.
  • When to get help.

To see all other Care Provider Bulletins click here.

Suicide Among People with Disabilities

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Using New Federal Funding to Meet Children’s Behavioral Health Needs in School

Since the pandemic began, there has been an increase in suicide rates among young people, particularly Black adolescents. Rates of attention-deficit/hyperactivity disorder, anxiety, and depression have also continued to rise as the long-term impact of COVID-19 plays out. Seven of 10 public schools report that the number of students seeking mental health services has increased since 2020. With students back in the structured environment of school, educators are working overtime to meet their behavioral health needs. Fortunately, the federal government has responded with unprecedented levels of support and efforts are underway to help schools put these new or dramatically expanded resources to good use.

The American Rescue Plan Act’s (ARPA) Elementary and Secondary School Emergency Relief (ESSER) provides more than $122 billion to help pre-K through grade12 students recover from lost time in schools by supporting their mental health, as well as their social, emotional, and academic needs. Additionally, the Bipartisan Safer Communities Act of 2022 commits more than a billion dollars in the next five years to support schools in addressing youth behavioral health needs, including funding for school mental health workforce. The law also directs the Department of Health and Human Services (HHS) and the Department of Education (DOE) to create a technical assistance center that will help states and schools better use Medicaid dollars for school-based services. In July 2022, DOE and HHS issued a joint letter to governors encouraging partnerships at state and local levels and outlining resources to support youth with behavioral health needs.

Read the full article from the Commonwealth Fund.

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New KFF/CNN Survey on Mental Health Finds Young Adults in Crisis

An overwhelmingly majority (90%) of Americans believe the nation is in the midst of a mental health crisis, and young adults appear to be suffering the most, a new KFF-CNN survey on mental health in America reveals.

A third (34%) of adults under age 30 rate their mental health as “only fair” or “poor,” compared to 19% of those ages 30 and older. Half (52%) say they “always” or “often” felt anxious over the past year (28% for older adults), and about a third say they always or often felt depressed (33%) or lonely (32%) in the past year, also significantly higher than for older adults (18% each among those ages 30 and older).

In addition, about a third (35%) of young adults say they have been unable to work or engage in other activities due to a mental health condition in the past year, a rate significantly higher than older adults.

Read the full article from KFF.

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Medicaid’s Essential Role in Improving the Mental Health of America’s Most Vulnerable Youth

Since well before the COVID-19 pandemic began, the number of young people diagnosed with a mental health need has been increasing, particularly among ethnic minorities, low-income households, and those involved with the child welfare and juvenile justice systems. In response, there has been an increased focus over the past year on strengthening behavioral health services for children and adolescents. A recent report from the Surgeon General describes “a national emergency in child and adolescent mental health” and offers several recommendations, including expanding access to response teams and funding community-based care systems to connect families with evidence-based interventions in their homes, communities, and schools.

Prevention and screening are also essential to meet the needs of young people at risk of mental health challenges. Fortunately, in 2013, the Centers for Medicare and Medicaid Services (CMS) issued guidance outlining the need to provide mental health and substance use treatment to members under age 21, including behavioral health screening and preventive services. Medicaid, which covers approximately 27 million young people, addresses this priority by offering the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, which requires states to provide medically necessary services to people under 21 who may be experiencing a mental health need. EPSDT is more comprehensive than commercial insurance benefits, ensuring access to physical and mental health care that promote healthy development and to treatment that addresses symptoms before they worsen. This is a powerful tool; Medicaid-eligible youth are entitled to EPSDT benefits regardless of whether the service is covered in their state’s Medicaid program.

The recent launch of the national 988 suicide and crisis hotline has spotlighted efforts to ensure the availability of behavioral health mobile crisis teams. But preventive services and behavioral health screening can prevent youth from requiring an intervention in the first place. The Center for Medicaid and CHIP Services estimates that 11 percent of youth have a mental health diagnosis, and that at least two-thirds of those youth were not identified as receiving any mental health service. Attending to the wellness of caregivers is also part of ensuring healthy children and strong attachment with caregivers. In 2016, CMS issued guidance allowing for maternal depression screens as part of the EPSDT benefit. A 2018 survey found 31 states and Washington, D.C., allow maternal depression screening to be billed under the child’s Medicaid.

Read the full article from the Commonwealth Fund.

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Patients Seek Mental Health Care From Their Doctor But Find Health Plans Standing in the Way

When a longtime patient visited Dr. William Sawyer’s office after recovering from covid, the conversation quickly turned from the coronavirus to anxiety and ADHD.

Sawyer — who has run a family medicine practice in the Cincinnati area for more than three decades — said he spent 30 minutes asking questions about the patient’s exercise and sleep habits, counseling him on breathing exercises, and writing a prescription for attention-deficit/hyperactivity disorder medication.

At the end of the visit, Sawyer submitted a claim to the patient’s insurance using one code for obesity, one for rosacea — a common skin condition — one for anxiety, and one for ADHD.

Several weeks later, the insurer sent him a letter saying it wouldn’t pay for the visit. “The services billed are for the treatment of a behavioral health condition,” the letter said, and under the patient’s health plan, those benefits are covered by a separate company. Sawyer would have to submit the claim to it.

But Sawyer was not in that company’s network. So even though he was in-network for the patient’s physical care, the claim for the recent visit wouldn’t be fully covered, Sawyer said. And it would get passed on to the patient.

Read the full article from KHN.

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Free Online Courses for Infant & Early Childhood Care Providers on Social-Emotional Competence

The courses were designed using the evidence-based Pyramid Model for Social Emotional Competence in Infants and Young Children which promotes and supports infant and early childhood mental health and the social emotional development of all children.

Course Titles

  • Building Relationships and Creating Supportive Environments
  • Social and Emotional Assessment and Targeted Social Emotional Strategies
  • Intensive Interventions

The courses were designed using the evidence-based Pyramid Model for Social Emotional Competence in Infants and Young Children which promotes and supports infant and early childhood mental health and the social emotional development of all children. As reflected in these three courses, the Pyramid Model takes a tiered public health approach to providing universal supports to all children to develop social emotional skills, targeted supports to those at risk, and intensive interventions for those who need them. All supported by an effective workforce, receiving training and coaching to support these practices in their settings. These self-paced interactive courses are rich with user-friendly training materials, videos, and print resources.

The first course, Building Relationships and Creating Supportive Environments, introduces the Pyramid Model, explores the relationship between challenging behavior and social emotional development, examines our attitudes about challenging behavior, and builds positive relationships between children and families. Adults interacting with children in a range of settings within diverse disciplines, including early intervention providers, early educators, families, and other professionals, gain new insight to the meaning behind challenging behavior and how to address it appropriately.

The second course, Social and Emotional Assessment and Targeted Social Emotional Strategies, provides information on implementing effective social emotional teaching strategies within the classroom. These strategies help infants and toddlers learn to express emotions appropriately, solve problems, and build friendships. Participants learn why teaching social emotional skills is important, when it is appropriate, which skills to teach, and how to teach them.

The last course in the series, Intensive Interventions, provides information on implementing individualized interventions for children who do not respond to regular intervention strategies implemented in the classroom. Most children will not need this level of support although some children need extra attention and individualized plans to support them to acquire the skills of self-regulation and positive peer and adult interaction. Participants learn to identify the functions of challenging behavior, how family trauma can impact a child’s expression of behavior, how to implement a behavior support plan, and how to support their team through the Pyramid Model during these scenarios in their classroom.

Behavioral Health Resources for Back to School

As we see students and educators head back into the classroom and restart the in-person learning routine, the Department of Health (DOH) is providing behavioral health tips and resources for navigating the emotional responses that children, teens, and adults may experience during this exciting and stressful time.

The COVID-19 Back-to-Classroom THINK Toolbox is a resource to help with adjusting to the return of in-person school and learning. THINK, which stands for Teaching with Healthcare Informed Neurological strategies for Kids, is a toolbox with information to help school-age children and teens deal with the emotional impacts of COVID-19, and tips on how to build and maintain resilience and practice self-care during a disaster.

“Children and teens are uniquely affected by the pandemic,” says Dr. Kira Mauseth, co-lead for the behavioral health strike team at the Department of Health. “Children and youth process information differently than adults. They need different structures in place to support them through disasters and large transitions, such as promoting recovery in the classroom, and return to back-to-classroom education. The THINK Toolbox was developed to address these areas and some of the trauma and stress that we’ve all experienced as a result of the pandemic.”

Increased anxiety, acting out, and behavioral regression at home or at school are some of the behavioral health responses that parents, caregivers and teachers are likely to see or encounter in students this fall. Also be aware of “red flag behaviors” such as suicidal thinking or expression (talking about it), violence, and aggression – these behaviors will require more or additional professional support. For children with autism spectrum disorder (ASD), they are twice as likely to experience more intense and more frequent behavior problems during the pandemic.

As schools are now open for in-person learning, ‘back to classroom’ education and recovery for students is also underway. When promoting recovery in the classroom, it is important to remember that some students come from groups that have been more severely impacted by the COVID-19 pandemic.

With this in mind, encouraging and building resilience for students is key! Activities that facilitate cooperation and communication, and helping children and youth develop self-efficacy (their belief in their ability to achieve a goal) are very important aspects for resilience in the classroom. Activities that also provide structure, consistency and the opportunity to contribute should also be strongly emphasized.

“As a parent and a physician, I know that in-person learning is hugely beneficial to children’s overall well-being,” says Umair Shah, MD, MPH, Secretary of Health. “In-person interaction helps ensure equitable access to education for all students. The work we do now to keep them safe will, in the long term, lead to a brighter and healthier future for our kids.”

Teachers, coaches, school staff, mentors, parents, and caregivers are also at risk for additional anxiety right now. For these groups, practicing self-care in the ways that specifically work for them, is the best medicine. More than ever, patience and compassion are required right now.

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Home for the Holidays: The Gift of Positive Behavior Support

Holidays can be challenging for families impacted by disability, trauma, grief, economic struggles, and other stressors. Holiday season 2020 has its own flavors of confusion. Families with children who struggle with behavior may want to head into the winter with plans in place. Anticipating where trouble could bubble up and developing a strategy for working it out provides all family members with opportunities for social-emotional growth, mindfulness, and rich moments.

PAVE consulted with a University of Washington (UW) expert in positive behavior supports to provide insight and information for this article. Kelcey Schmitz is the school mental health lead for the Northwest Mental Health Technology Transfer Center, housed at the UW School Mental Health Research and Training (SMART) Center. An area of expertise for Schmitz is Multi-Tiered Systems of Support (MTSS), a framework for schools to support children’s academic, social, emotional, and behavioral strengths and needs at multiple levels. An MTSS framework makes room for Positive Behavioral Interventions and Supports (PBIS). When done well, PBIS teaches and reinforces positive social skills, communication strategies and “restorative justice” (working it out instead of punishing).

“This holiday season may present additional challenges given the pandemic,” Schmitz says. “Families, like educators, need to go back to the basics during times of stress and uncertainty. Remembering core features of PBIS at home, such as predictability, consistency, safety, and positive interactions are going to be key. In fact, lessons learned during stay-at-home orders during the pandemic can and will carry us through the holidays and beyond. Never before have routines, regulation, relationships, and reinforcement been more important for everyone in the family than they will be this winter.”

Schmitz has provided articles and content to support PAVE families over the years and offers the following tips for navigating the holidays by using PBIS strategies at home.

Read the full article from PAVE.