A public health crisis in and of itself, the precarious mental health of young people in the United States has only been exacerbated by the COVID-19 pandemic, according to a July report by Mental Health America, Addressing The Youth Mental Health Crisis: The Urgent Need For More Education, Services, And Supports. The report found that, in spite of the worsening condition of youth, public policy has been slow to respond both nationally and at the state level.
A June release from the Centers for Disease Control and Prevention found that mental health-related emergency department visits in the United States for those ages 12-17 increased 31 percent from 2019 to 2020. Emergency department visits for suspected suicide attempts started to increase in the age group in May 2020, especially among girls. That trend has continued into 2021.
The Mental Health America report cites 2019 National Survey on Drug Use and Health data that indicates “the percentage of youth ages 12-17 who reported experiencing a past-year major depressive episode had doubled over the past decade. Disparities continue, and Black and Latinx children are less likely than white youth to receive treatment for their depression, including inpatient treatment, though they are no less likely to have a major depressive disorder.”
The document details these “alarming trends” and offers innovative solutions for state legislators such as school-based mental health education, supports and services that can serve as a framework for future federal policy. Also highlighted is the role of youth leadership in shifting policy and the ways in which such polices advance equity.
Current situation and suggestions
While some states have enacted mental health policies, most lack comprehensive ones that span the areas of mental health education, mental health services and excused absences for mental health days.
The report found that mental health education generates positive outcomes, citing a recent meta-review of research concluding that educating high schoolers with a mental health curriculum was one of the few policies proven to reduce suicide attempts and ideation.
States like New York, Virginia and Florida require some level of mental health education. In California, Senate Bill 224 would require students to receive mental health education multiple times from a qualified instructor as they rise through the K-12 education system. The bill would also require the California Department of Education to develop a plan to expand mental health instruction in public schools on or before Jan. 1, 2024.
Securing access to mental health services for those who need them is also key.“Access to mental health services begins with early intervention by school personnel. Some states have enacted and funded lower ratios of counselors and social workers to students to improve the number of health professionals in schools,” the report states. “Only 14 states have fully expanded Medicaid to cover services outside of those detailed in an Individualized Education Plan [sic], though several others are in progress. Very few children have an IEP.”
States like Minnesota and Kansas have successful programs involving community-based mental health providers that have been helpful in addressing inequity, with data indicating that students of color gain access to mental health care when treatment is provided at school, according to the report.
The report stressed the need for student support when youth are unable to attend school for mental health reasons in addition to the more traditional physical health concerns. States that have passed legislation allowing for excused absences for mental and behavioral health-related reasons include Oregon, Colorado, Maine, Utah, Connecticut and Virginia.
The report also highlighted the importance of youth leadership in developing and passing legislation.
Recommendations for improving mental health access and services include:
- Promoting youth leadership at the local, state and national levels
- Advocating for and achieving state legislative victories in the realms of mental health education, access to services and mental health excused absences. This includes ensuring follow-up, evaluation and effective implementation of legislation
- Continuing innovation and research on evolving state statutes and programs to improve early intervention in youth mental health, particularly in the areas of screening and peer support
- Drawing on state experiences to inform a national strategy and implementation to improve youth mental health with an emphasis on youth leadership, equity and school initiatives
“With youth mental health declining and worsening during COVID-19, more urgency is needed at the local, state, and national levels,” the report concludes. “The efforts highlighted here should be enacted in communities and across states, and policy initiatives led by youth must be further developed at all levels of government.”