News Mashup for December 2021
Surgeon General’s Youth Mental Health Advisory
U.S. Surgeon General Dr. Vivek H. Murthy issued a Mental Health Advisory on December 7, 2021 warning that “Mental health challenges in children, adolescents, and young adults are real, and they are widespread.” Advisories are “reserved for significant public health challenges that need the nation’s immediate awareness and action” says Murthy, citing an alarming increase of depression and anxiety in youth, which doubled during the ongoing COVID-19 pandemic. The Advisory stresses that mental health must be recognized an essential part of overall health and that high-quality, affordable, and culturally competent mental health care must be readily available.
Writing for CalMatters, Secretary of the California Health and Human Services Agency, Mark Ghaly, and Linda Darling-Hammon, President of the California State Board of Education, said: “California is already taking action on many of the Surgeon General’s recommendations.” The 2021-2022 state budget invested $4.4 billion on a “bold new initiative to transform the state’s children and youth behavioral health system.” The focus of the initiative is on prevention and early action. Under the initiative, all young people ages 0 to 25 would be routinely screened and receive services for emerging and existing mental health needs. The budget also included $3 billion for funding community schools that provide wraparound services.
This whole-child approach to education is gaining traction nationally. National Public Radio’s member station KQED aired a segment on December 23 that gives a snapshot of what schools are currently doing to address students' social-emotional needs. Based on a Department of Education September 2021 review of 170 school districts:
59% are offering specialized professional development to existing staff members,
42% have hired new staff, such as counselors and social workers,
26% have added student classes to address topics related to social, emotional or mental well-being, and
20% have created community events and partnerships.
A poll published by National Alliance on Mental Illness (NAMI) on December 15, 2021 indicates that parents overwhelmingly want mental health education and services in schools (87% of those polled). That said, the poll shows a “worrying gap between those [parents] who have concerns and those who actually look for help.” The poll found that of the 44% of parents that reported being concerned about their children’s mental health, only 16% looked for help. But, as a recent survey by the American Psychological Association (APA) shows, help is not so easy to find.
During a December interview with the Washington Post, APA’s Chief Executive Officer, Daniel H. Gillison, bemoaned the disparity of society’s workforce investment in mental health relative to physical health. Compared to last year “ the APA [survey] found that waiting lists and referrals have nearly doubled, while 41 percent of psychologists reported being unable to treat all of their patients…unfortunately, now we’re paying for that disparity because we see that we just don’t have the workforce available [to meet the existing challenge].”
Writing for the Los Angeles Times, investigative reporters Howard Blume and Melissa Gomez summarize the dilemma in two short sentences: “Historically, the problem has been the lack of money to hire counselors. For now, the money is there, but the professionals are not.” Click on the links below to learn more.
Vivek H. Murthy. December 7, 2021. Protecting youth mental health: The U.S. Surgeon General’s Advisory. U.S. Department of Health and Human Services. Retrieved December 18, 2021 from https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf.
The Kennedy Forum. December 9, 2021. State policy platform for addressing the U.S. mental health & addiction crisis. Retrieved December 18, 2021 from https://www.thekennedyforum.org/app/uploads/2021/12/2021-State-Policy-Platform_Final.pdf .
Mark Ghaly and Linda Darling-Hammond. December 13, 2021. We need to ensure the mental health and well-being of all our children. CalMatters. Retrieved December 18, 2021 from https://calmatters.org/commentary/2021/12/we-need-to-ensure-the-mental-health-and-well-being-of-all-our-children/.
National Alliance on Mental Illness. December 15, 2021. Poll of parents amid the COVID-19 pandemic (2021). Retrieved December 31 from https://www.nami.org/Support-Education/Publications-Reports/Survey-Reports/Poll-of-Parents-Amid-the-COVID-19-Pandemic-(2021) .
National Alliance on Mental Illness. December 15, 2021. NAMI poll: Parents want mental health education in schools, mental health days off for students. NAMI Press Release. Retrieved December 18, 2021 from https://www.nami.org/Press-Media/Press-Releases/2021/NAMI-Poll-Parents-Want-Mental-Health-Education-in-Schools-Mental-Health-Days-Off-for-Students .
Howard Blume and Melissa Gomez. December 17, 2021. Surgeon General warns of emerging youth mental health crisis in rare public advisory. Los Angeles Times. Retrieved December 18, 2021 from https://www.latimes.com/california/story/2021-12-07/surgeon-general-advisory-youth-mental-health-crisis-looms .
Ali Tadayon. December 7, 2021. U.S. Surgeon General warns of youth mental health crisis. EdSource. Retrieved December 18, 2021 from https://edsource.org/updates/u-s-surgeon-general-warns-of-youth-mental-health-crisis .
Collin Binkley and Hannah Fingerhut. December 6, 2021. Pandemic stress weighs heavily on Gen Z: AP-NORC, MTV poll. AP News. Retrieved December 18, 2021 from https://apnews.com/article/coronavirus-pandemic-health-lifestyle-anxiety-generations-d79bee29d08f68b85c5b537ebf5004ed .
Steven Ross Johnson. December 7, 2021. Surgeon General advisory raises alarm on youth mental health. U.S. News & World Report. Retrieved December 18, 2021 from https://www.usnews.com/news/health-news/articles/2021-12-07/surgeon-general-issues-advisory-on-youth-mental-health .
María Luisa Paúl. December 7, 2021. A youth mental health crisis was already brewing. The pandemic made it worse, Surgeon General says. Washington Post. Retrieved December 18, 2021 from https://www.washingtonpost.com/health/2021/12/07/surgeon-general-youth-mental-health/.
Anya Kamenetz. December 23, 2021. Here's what schools are doing to try to address students' social-emotional needs. NPR KQED Northern California. Retrieved December 31, 2021 from https://www.npr.org/2021/12/23/1064975215/heres-what-schools-are-doing-to-try-to-address-students-social-emotional-needs .
CalAIM Gets Federal Approval
On December 29, California received federal approval to launch CalAIM (California Advancing and Innovating Medi-Cal), a 5-year plan to transform the state’s managed care delivery systems into a more “equitable, coordinated, and person-centered” structure.
California Department of Health Care Services says that investment in CalAIM is “driven by the stark inequities in access to health care by race, ethnicity, and income. The COVID-19 public health emergency amplified these inequities.”
Presently, one in three Californians depend on Medi-Cal for their health coverage; more than half of California’s school-age children depend on Medi-Cal; and Medi-Cal covers more than 2 of 3 patient days in long-term care facilities. In the behavioral and mental health arena, CalAIM is intended to:
1) Create a new model of care for foster children and youth, with a strong emphasis on behavioral health services and care coordination, aligned with national reform efforts.
2) Fund development of critical infrastructure to expand the continuum of behavioral health services in the community (e.g., mobile crisis, wellness centers, residential, acute psychiatric).
3) Help counties optimize resources through collaborative and regional administration and delivery of specialty mental health and substance use disorder services.
4) Clarify that children can receive family therapy services without a diagnosis and expanding use of dyadic therapy (i.e., treatment delivered to a parent and child simultaneously).
5) Establish a “no wrong door” approach for enrollees to quickly and easily access mental health and substance use disorder services, regardless of the delivery system where they initially seek care.
Click on the links below to learn more.
California Department of Health Care Services. December 29, 2021. California’s historic Medi-Cal transformation to improve and expand services gains federal approval. Retrieved December 29, 2021 from https://www.dhcs.ca.gov/formsandpubs/publications/oc/Documents/2021/21-08-CalAIM-12-29-21.pdf .
California Department of Health Care Services. July 2021. California Advancing and Innovating Medi-Cal (CalAIM). Retrieved December 31, 2021 from https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-BH-a11y.pdf .
Examining Wraparound Outcomes
A comparison of the effects of Wraparound with Treatment-As-Usual (TAU) services for youth with Serious Emotional Disorders (SED) was published in the most recent issue of the Journal of American Academy of Child Adolescent Psychiatry. The authors analyzed data from peer-reviewed studies published between 1996 and 2019 to answer the following:
Compared to TAU, what effects does Wraparound have on youth outcomes, including mental health symptoms, mental health functioning, juvenile justice outcomes, school functioning, and residential placement?
Compared to TAU, what effects does Wraparound have on service costs for youths with SED?
Across different outcome categories, the most significant benefits of Wraparound were found in placement prevention (outside the home) and reduced service costs; Wraparound produced only small improvements to mental health symptoms and functioning, and had negligible effects on juvenile justice outcomes.
The authors conclude that these results “are likely to be particularly appealing to policy makers, system leaders, and managed care organizations seeking to reduce reliance on congregate care and direct resources “upstream” to prevention and early intervention.” Click on the links below to learn more.
Jonathan R. Olson, Philip H. Benjamin, Alya A. Azman, Marianne A. Kellogg, Michael D. Pullmann, Jesse C. Suter, Eric J. Bruns. December 2021. Systematic review and meta-analysis: Effectiveness of Wraparound care coordination for children and adolescents. J Am Acad Child Adolesc Psychiatry. Retrieved December 17, 2021 from https://www.jaacap.org/article/S0890-8567(21)00155-6/pdf .
Elsevier. December 3, 2021. Wraparound care coordination associated with many positive outcomes amongst youth with serious and complex behavioral health needs. Science Daily. Retrieved December 17, 2021 from https://www.sciencedaily.com/releases/2021/12/211203095807.htm .
More Stories in December: “They took us away from each other”: Lost inside America’s shadow foster system ProPublica — 12.01.2021; Suicide prevention and racial inequity in mental health SafeSpace 12.05.2021; Thurmond plan would add 10,000 mental health clinicians to California schools EdSource — 12.21.2021; There aren’t enough mental health professionals despite a tsunami of need. Here’s what S.F. is doing about it San Francisco Chronicle — 12.22.2021; States are hoarding $5.2 billion in welfare funds even as the need for aid grows ProPublica — 12.29.2021; Teen drug use decreased in 2021, according to a new national survey NPR Indianapolis — 12.22.2021; Black students stage protests and walkouts in response to racism and bullying in schools The Root — 12.05.2021; Youth in THP-NMD and THP-Plus: A 2020-21 census JBAY — 12.01.202; Fauci calls mental health a 'very important and difficult' part of pandemic The Hill — 12.30.202; The youth mental health crisis is real, but teachers can't solve it alone The Hill — 12.30.2021; Progress on juvenile justice reform in California CATO Institute — 12.22.2021; Want to improve mental health? Reducing poverty is key Psychology Today — 12.06.2021; How one California school district is using its Covid relief money to help students EdSource — 12.16.2021; 1 in 100 kids lose legal ties to their parents by the time they turn 18. This new bill aims to help PBS News Hour — 12.30.2021.
