Our current health care system does not meet the needs of children with mental health disorders. Although 1 in 5 children in the United States suffers from a diagnosable mental health disorder, only 21% of affected children actually receive needed treatment. Mental illness is like any other disease; the earlier it is identified and treated, the better the health outcomes.
The AAP has been advocating that Congress to promote children's mental health by adopting policies that will develop a robust workforce of child and adolescent mental health specialists, facilitate the ability of primary care pediatricians to provide early identification and treatment for children with mental health disorders, and improve school-based mental health services and supports.
The AAP approaches mental health as a component of overall health, and has long-standing support for federal mental health parity, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA). In April 2015, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule outlining the application of MHPAEA to Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs), and the Children's Health Insurance Program (CHIP). AAP has submitted comments on the proposed rule and will continue to ensure that children have access to robust mental and behavioral health benefits.
The AAP Department of Federal Affairs has been working to promote care and payment models that better integrate behavioral health in the pediatric primary care setting. One such approach is through support for statewide child psychiatry access programs. These innovative programs such as the Massachusetts Child Psychiatry Access Project and the Behavioral Health Integration in Pediatric Primary Care in Maryland program, support pediatricians' efforts to assess and manage mental health needs of children from infancy through adolescence through phone consultation, continuing education and resource and referrals. Senators Bill Cassidy (R-La.) and Chris Murphy (D-Conn.) included a provision in their expansive mental health legislation, the Mental Health Reform Act of 2015 (S. 1945), that provides a federal grant program to support the creation and expansion of statewide child psychiatry access programs. AAP is working on a companion proposal in the House of Representatives.
Mental Health Legislation: Where AAP Stands
Exposure to violence causes toxic stress in childhood, which can have long-term negative effects on children. Managing adult mental health disorders begins with ensuring that children have access to quality mental health services.
The AAP has endorsed the following proposals this Congress:
- The Bringing Postpartum Depression Out of the Shadows Act (H.R. 3235), introduced by Reps. Katherine Clark (D-Mass) and Ryan Costello (R-Pa), which aims to expand awareness, screening, and treatment for postpartum depression. (Endorsement letter)
- The Children's Recovery from Trauma Act of 2015 (S. 1494, H.R. 2632), which would reauthorize the National Child Traumatic Stress Network (AAP & Mental Health Liaison Group support letter)
- The Mental Health in Schools Act of 2015, introduced in the Senate by Senator Al Franken (D-Minn.) and in the House by Representative Grace Napolitano (D-Calif.), which provides access to more comprehensive school-based mental health services and supports (AAP & Mental Health Liaison Group support letter)
- The Mental Health Awareness and Improvement Act of 2015 (S. 1893, introduced by Senator Patty Murray (D-Wash.) and Senator Lamar Alexander (R-Tenn.), which reauthorizes and improves programs related to awareness, prevention and early identification of mental health conditions and promotes linkages to appropriate services for children and youth. (AAP & Mental Health Liaison Group endorsement letter)
- The Family Stability and Kinship Care Act of 2015 (S. 1964) introduced by Senator Ron Wyden (D-Ore.) opens up new eligibility for services, including child and parental mental health services, as a way to prevent the need for foster care. (AAP statement)
- The Ensuring Children's Access to Specialty Care Act of 2015 (H.R. 1859) introduced by Reps. Chris Collins (R-NY) and Joe Courtney (D-Conn.), which would amend the Public Health Service Act to include pediatric subspecialists in the National Health Service Corps (NHSC) loan replacement program. (Endorsement letter)
- The Garrett Lee Smith Memorial Act Reauthorization of 2015 (H.R. 938, S. 1299) reauthorizes the Garrett Lee Smith Memorial Act, signed into law by President George W. Bush in 2004, and would continue commitment to important youth and college suicide prevention programs. (AAP & Mental Health Liaison Group endorsement letter)
- AAP mental health resource website: www.aap.org/mentalhealth
- AAP health and mental health needs of children in U.S. military families clinical report
- AAP school-based mental health services policy statement
- AAP mental health competencies for primary care policy statement
- A letter to the Senate Finance Committee outlining recommendations on how to address the mental health needs of children and adolescents signed by AAP and more than 30 other organizations.
- A letter to Senate and House leadership from the Child and Adolescent Mental Health Coalition, of which AAP is a founding member, describing our priorities for mental health reform.
- AAP's Sept. 2013 response to the Senate Finance Committee outlining recommendations on how to best address the mental health needs of children and adolescents