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.

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.

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.

988 Suicide and Crisis Lifeline Launches

988 is the new, nationwide, three-digit dialing code for the Suicide and Crisis Lifeline. The 988 dialing code connects people via call, text, or chat, to the existing National Suicide Prevention Lifeline (NSPL) where compassionate, accessible care and support are available for anyone experiencing mental health-related distress. 988 is the newest addition to the state’s network of crisis center providers and will not replace any crisis call centers in Washington. The current NSPL number, 1-800-273-TALK (8255), will remain active along with the new 988 dialing code.

“Thanks to the many partner organizations and agencies who have made this resource possible,” said Governor Jay Inslee. “In the same way 911 transformed our ability to respond to emergency safety or health situations, 988 will transform our ability to connect people to help in behavioral and mental health crisis situations.”

“Providing an easy-to-remember, three-digit number is an important step to accessing potentially life-saving support,” said Umair A. Shah, MD, MPH, Secretary of Health. “We are dedicated to enhancing and expanding behavioral health crisis response and suicide prevention services for all Washingtonians.”

In addition to activating a new dialing code for anyone experiencing suicidal or mental health-related crisis to call, the 988 Suicide and Crisis Lifeline also allows text messaging as part of increasing access to services for youth and individuals with different abilities. People can also dial or text 988 if they are worried about a loved one who may need crisis support. 988 will be available 24/7 and is free and confidential.

Call services will be available in Spanish, along with interpretation services in over 250 languages. Spanish speakers may reach the Spanish Language Line by pressing 2 after dialing 9-8-8 or 1-800-273-TALK (8255). Text and chat services are available in English only.

Veterans and service members may reach the Veterans Crisis Line by pressing 1 after dialing 9-8-8 or 1-800-273-TALK (8255). Soon, Washington will also be able to launch a Native and Strong Lifeline, dedicated to serving Washington’s American Indian and Alaska Native individuals.

People who are deaf, hard of hearing, and TTY users should use your preferred relay service or dial 711 then 1-800-273-8255.

Digital Mental Health Companies Draw Scrutiny and Growing Concerns

When Pat Paulson’s son told her he was feeling anxious and depressed at college, Paulson went through her Blue Cross Blue Shield provider directory and started calling mental health therapists. No providers in the Wisconsin city where her son’s university is located had openings. So she bought a monthly subscription to BetterHelp, a Mountain View, California, company that links people to therapists online.

Her son felt uncomfortable with his first BetterHelp therapist. After waiting several weeks, he saw a second therapist, whom he liked. But she wasn’t available the following week.

Despite the switch and the wait, Paulson is grateful she was able to find her son help. “He was getting to the point where he was ready to give up trying to find someone,” she said.

Many U.S. adults aren’t able to find help because of a shortage of therapists. Nearly 40% are struggling with mental health or substance abuse issues, according to the Centers for Disease Control and Prevention.

Read the full article from KHN.

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.

Mental Health Therapists Seek Exemption From Part of Law to Ban Surprise Billing

Groups representing a range of mental health therapists say a new law that protects people from surprise medical bills puts providers in an ethical bind and could discourage some patients from care.

The therapists take no issue with the main aim of the legislation, which is to prevent patients from being blindsided by bills, usually for treatment received from out-of-network medical providers who work at in-network facilities. Instead, they are concerned about another part of the law — a price transparency provision — that requires most licensed medical practitioners to give patients detailed upfront cost estimates, including a diagnosis, and information about the length and costs involved in a typical course of treatment. That’s unfitting for mental health care, they say, because diagnoses can take time and sometimes change over the course of treatment.

Read the full article at KHN.

Self-Regulation Strategies for Young Students

Here are some simple self-regulation supports you can utilize with your students (pre-K through grade 5) to address emotional dysregulation, an inability to manage emotional responses well.

SIMPLE BUT EFFECTIVE EXERCISES

1. Hand hold: This small-movement physical exercise provides crossing midline (i.e., where one arm or leg crosses to the other side of the body) and proprioceptive (deep pressure) inputs, so it’s a good choice to use when your students are feeling low physical energy, high physical energy, or high levels of emotionality.

Directions for students:

  • Place your palms together.
  • Cross your thumbs.
  • Hold your own hands together tightly and squeeze, keeping your elbows close to your body.
  • Repeat as needed.

2. Folded coat or sweatshirt: Sitting on a raised surface provides your students with vestibular input (any change in position, direction, or movement of the head), which helps get the nervous system out of fight-or-flight mode—so this can be a useful tool if your students are feeling high levels of emotionality. It also can help wake them up if they are low energy.

Directions for students:

  • Alternative 1: Place your folded coat or sweatshirt on the seat of your chair; sit on the folded clothing and firmly plant your feet on the floor.
  • Alternative 2: With a controlled body, try lying on your belly lengthwise across a single row of heavy books placed end to end, balancing carefully, for as long as you can hold yourself steady with flat palms, while also supporting yourself with your legs stretched out, feet reaching the floor. Put the books on a carpeted area to keep them in place.

Read the full article from Edutopia.

10 Helpful Ways You Can Manage Family Stress During the Holidays

The holiday season is often filled with fun and family, but it can also be stressful. A 2018 survey found that an overwhelming majority (88%) of those surveyed feel stressed when celebrating the holidays.

Family dynamics play a major factor in how much you and your loved ones may enjoy the holidays. Here are 10 ways to manage family-related stress and help you experience more joy with your family.

#1 Talk in advance to set expectations around gift-giving.

When spending on holiday gifts is uneven or gifts are unexpected, it can lead to awkward and even unhappy moments with family. Have a brief conversation up front to set the ground rules and agree on a spending range. For many families, drawing names and giving to just one person offers a way to reduce financial strain while others choose experiences they can do together, like seeing a local theater show, and eliminate gifts altogether.

Conversation starter: “We thought it would be helpful to make a plan for gifts this year, as we need to stick to a budget. Can we agree on a spending limit?” 

Read the rest of the article from Families for Depression Awareness.

The Pandemic’s Impact on Children: COVID Vaccinations & Mental Health

Children’s health care professionals in the US have declared a national state of emergency in child and adolescent mental health. The ongoing stress, fear, grief, disruption of schooling and uncertainty created by the COVID-19 pandemic has weighed heavily on children and teens, and many are having a tough time coping emotionally.

Read the full article from NIHCM