It’s well known that there is a child mental health crisis. One national survey from the CDC shows that almost all signs of poor mental health among teens worsened between 2013 and 2023.
That’s why the Bipartisan Policy Center created the Youth Mental Health and Substance Use Task Force. The task force is focused on creating policy solutions centered around youth mental health for Congress and the administration. And on Tuesday, the group released its second of three reports. This one is focused on redesigning the healthcare system to support youth, while the first centered around safe and secure social media use and the third will cover prevention and early identification of mental health disorders.
“A common refrain among child-serving health care professionals is that the health care system and its financing mechanisms are not designed to optimally serve youth and their families. BPC’s Youth Mental Health and Substance Use Task Force aims to change that,” the report stated.
Here are five ways the healthcare delivery system can better support youth, according to the second report:
1. Strengthen the behavioral health workforce: The task force recommends supporting states in growing their behavioral health workforce by reducing insurance credentialing challenges, expanding behavioral health providers’ inclusion in insurance networks, enhancing participation in interstate licensure compacts, and improving licensure portability.
For example, the report states that Congress should authorize the Department of Health and Human Services to offer grants of up to $2 million over three years to form 10 regional behavioral health education centers. The task force also recommends streamlining the credentialing process for Medicaid by allowing providers to submit one credentialing application packet with standardized criteria, versus making them apply to multiple Medicaid managed care plans.
2. Ensure increased transparency and compliance with screening and treatment requirements: The government should ensure compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA), which requires that insurance coverage of mental health conditions be no more restrictive than of medical conditions.
For example, Congress should approve up to $10 million in annual grants to state Medicaid agencies to build expertise in MHPAEA. They should also mandate that state Medicaid programs and Children’s Health Insurance Programs include provisions in their managed care contracts requiring Medicaid managed care plans to perform parity analyses.
3. Promote integrated primary care and behavioral health: There needs to be improved screening, consultation, referral and treatment for mental health and substance use in both primary care and pediatric settings, according to the report.
The task force recommends that CMS provide education and technical assistance to states on promoting integration in pediatric settings. Additionally, Congress should raise reimbursement rates to better support pediatric providers.
4. Support youth with highest acuity needs: The task force recommends expanding access to substance use treatment and intensive home and community-based services for youth, particularly for those who are high-risk or involved in the justice system.
The report’s specific recommendations include directing the National Institutes of Health to research treatment for youth with co-occurring mental health and substance use disorders. In addition, the Department of Justice should advance data collection for youth who are incarcerated and determine ways to decrease youth suicide and suicide risk in jails, prisons and after release.
5. Improve crisis and stabilization systems: The government should take steps to grow the capacity of the crisis workforce, such as emergency medical personnel. They should also improve crisis system financing.
For example, SAMHSA and CMS should send a letter to state Medicaid directors encouraging the use of evidence-based crisis and stabilization models, including the Mobile Response and Stabilization Services for children. CMS should also offer technical assistance to states on how to access the enhanced federal match for mobile crisis services under the American Rescue Plan Act and extend this funding opportunity for another three years.
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