4 Goals for Expanding the Mental Health Care Policy for Children and Youth

Change is the air, and everyone is cautiously optimistic for healthcare reform in the new administration. In the coming years, the national mental health organizations will begin expanding behavioral healthcare agenda for children and youth, and are looking to new members to help shape and prioritize policy goals. Focusing on children and youth is an important starting point.

With several healthcare reform proposals on the table from Congress, national mental health care organizations are working on a number of fronts to advance children’s behavioral healthcare in the new Administration. A top priority is securing additional Medicaid support through increased SCHIP funding and Federal Medical Assistance Percentages. In addition, mental health organizations are working closely with federal partners to include behavioral health issues for children and youth in federal initiatives. The unique healthcare needs of children are a priority in any health reform proposal.

Other child health policy goals will likely mirror and advance the objectives of many community mental health organizations around the US. The following four goals are objectives that are universally accepted by many mental and behavioral health care providers.

1.) Service needs, rather than financing streams, should shape the structure of delivery systems for children and youth.

Often, the rules and regulations governing coverage and reimbursement narrowly dictate how and which clients can be served. Early diagnosis and intervention remains more of a vision than the reality. Federal and state financing need to support — not impede — early intervention and prevention, care for the “whole child,” and incentives for statewide approaches to improving age-appropriate services.

2.) Behavioral health services for children and adolescents require a family focus

Child disorders can engender dysfunction even in relatively strong families. This phenomenon is especially challenging in families that may have difficulty accessing medical appointments or taking time off work. Policy should support services delivered by behavioral and mental health organizations in and across natural settings such as early childhood programs, homes, primary health care settings, and schools in order to successfully reach children and their families. More and more community mental health organizations are helping families obtain supports beyond traditional services like income support or public health insurance.

3.) Delivery systems should be both flexible and accountable

The focus on mental health care for children should dovetail with ongoing efforts to use data to drive clinical and administrative decision-making. Delivery systems must be flexible to support collaboration between providers and service sites that treat the “whole” individual while also being more attentive and responsive to functional outcomes. To do this, child mental health authorities, child welfare authorities, and state juvenile courts, in conjunction with federal partners, must develop a comprehensive strategy to work together in new ways: more cooperatively, transparently, effectively and efficiently.

These delivery systems need to be able to jointly measure effectiveness of services over time and to coordinate services within or between systems in order to improve outcomes experienced by children and their families. Meaningful, measurable, and manageable measures of performance across systems are critical. Community mental health organizations need to work closely with their members to advance policy that improves interagency financing and service networks, to develop methodologies for integrating and coordinating mental health resources for children and families, and to create a quality driven mental health system.

4.) Increase workforce capacity and competence, with greater attention to cultural responsiveness

Everyone needs to work at the federal and state levels to build a qualified and adequately trained workforce — one prepared to recognize, diagnose and provide mental health services for children and their families and a workforce trained to deliver care and treatment under a new paradigm that stresses collective responsibility for child mental health and well-being.

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