Contact: Michelle Pruett (703) 838-7538
mpruett@nmha.org

By Michael Faenza, President and CEO

ALEXANDRIA, VA (September 19, 2000)  Building on the groundbreaking work of Mental Health:  A Report of the Surgeon General, today’s meeting is a hopeful step in addressing the mental health needs of our nation’s children and youth.  In holding this conference, Children’s Mental Health:  Developing a National Action Agenda, Surgeon General David Satcher continues his outstanding leadership on an issue that has been ignored for too long. 

Mental health problems in children and youth are real, common, and treatable.  However, only one-third of all young people with mental health problems get any treatment and fewer receive appropriate care.    

There are major consequences in neglecting the mental health needs of children and their families.  Mental health problems can disrupt daily functioning at home, school and in the community.  Failure to provide adequate mental health services to children who need them can increase risk of school failure, involvement with the criminal justice system, dependency on social services and even suicide.  In adulthood, untreated children’s emotional disorders may lead to co-occurring mental illness and substance abuse disorders, homelessness, and incarceration.

To best meet the needs of children and families, the National Mental Health Association (NMHA) has identified two overarching concerns for our nation’s attention and commitment:

1.      Expanding access to mental health services for children and families

Too many children and families have difficulty accessing services because of insurance inadequacies, stigma and system fragmentation. A number of opportunities currently exist to expand access to mental health services for children and families, and we must take full advantage of them.

Insurance Parity: Most people would not deny a child access to care for a physical health problem such as diabetes, asthma or epilepsy. Why do we deny treatment to a child with a mental health problem? NMHA believes there should be nondiscriminatory insurance coverage for adults and children.  S. 796, the Mental Health Equitable Treatment Act of 1999, introduced by Sens. Pete Domenici (R-NM) and Paul Wellstone (D-MN), would provide mental health parity in co-pays and deductibles for particular mental health diagnoses.  While NMHA supports the direction of this legislation, we would like the bill to be expanded to provide full coverage for children’s mental health disorders.

EPSDT:   Many of our nation’s children can and should receive services through the Medicaid Early Periodic Screening Diagnosis and Treatment (EPSDT) program.  The federal government must provide better oversight to ensure that states implement the program and identify kids earlier.  We cannot overstate the savings in human and financial costs that arise from identifying and treating children’s mental health problems at the earliest possible point. 

State Children’s Health Insurance Program (S-CHIP):  The federal investment in this historic initiative must continue.  States must also expand their outreach to cover the millions of children in this country who remain uninsured.

2.  Ensuring a continuum of care for all children and families

Children and families should have access to comprehensive care that meets their individual needs. A full continuum of care must include prevention, early intervention and treatment services for the full range of problems experienced by our nation’s children. 

Systems of care:  The Surgeon General confirmed that collaborative, family-centered and community-based systems of care are effective in meeting the needs of families and children. 

NMHA calls upon all child and family-serving agencies – including schools, child welfare, primary care, and juvenile justice systems – to work together to better serve children and families. NMHA strongly supports increased appropriations that enable inter-agency collaboration, including an increased investment in the federal Center for Mental Health Services’ Children’s Mental Health Services grant program. 

Prevention: Preventative care and the identification of mental health needs must be available for children and families in various settings such as schools, primary care, and juvenile justice.  NMHA supports passage of S. 2639, the Mental Health Early Intervention, Treatment and Prevention Act of 2000, sponsored by Sens. Pete Domenici (R-NM) and Edward Kennedy (D-MA).  The bill would improve and expand services for children and adults with mental illness, and provide prevention programs for millions more.

Substance abuse:  The Surgeon General’s Report acknowledges the high rates of co-occurring mental health and substance abuse disorders in children and adolescents.  We must ensure that developmentally appropriate treatment and services for children with mental health and co-occurring substance abuse disorders are available and integrated. 

Medications: In addition to therapy and support services, medication may be part of a comprehensive treatment plan for some children with mental health needs.  While new research from the National Institute of Mental Health shows that the most widely prescribed psychotropic medications for children (stimulants and selective serotonin reuptake inhibitors) are safe and effective, more research should be conducted to determine which children could benefit from medications, how long they should remain on medications at what dosage, and how these medications affect children over the long term.  Moreover, the Food and Drug Administration should work to develop labeling information on the appropriate use of medications for children and adolescents. The lack of pediatric labeling contributes to the controversy over the use or misuse of medications; this type of controversy obscures the fact that most youth with mental health problems do not get any help at all.  It is stigmatizing and may discourage families from seeking help they need.