News Mashup for February 2023
Teen Mental Health—Trends from 2011 to 2021
In February the Centers for Disease Control and Prevention (CDC) released an analysis of 10 years’ worth of data on adolescent health and well-being. The analysis uses information from the Center’s Division of Adolescent and School Health biannual Youth Risk Behavior Survey of U.S . high school students.
There is good news — risky sexual behavior, use of drugs and alcohol, and the experience of being bullied are on the decline. Unfortunately, other indicators of health and well-being, show worsening trends, especially for girls and LGBTQ+ youth. In particular, mental health problems including depression, suicidal thoughts, and self-harming behavior have increased since 2011.
Commenting on the CDC report in a February issue of Time, Jean M. Twenge, a Professor of Psychology at San Diego State University, said that these disturbing trends are not the result of the COVID-19 pandemic. By way of example, Professor Twenge points out that the CDC data shows a doubling of teen depression between 2010 and 2019, a trend that continued during the pandemic years at the same rate.
Research published earlier by Professor Twenge and colleagues mirror the CDC results. The following scientific summary is taken verbatim from their 2019 article in the Journal of Abnormal Psychology:
More U.S. adolescents and young adults in the late 2010s (vs. the mid-2000s) experienced serious psychological distress, major depression, and suicidal thoughts, and more attempted suicide and took their own lives. These trends are weak or nonexistent among adults 26 years old and over, suggesting a generational shift in mood disorders and suicide-related outcomes rather than an overall increase across all ages.
Their research uses 2005-2017 data from the National Survey on Drug Use and Health, and represents responses from more than 600,000 adolescents and adults.
Click on the links below to learn more.
Centers for Disease Control and Prevention. February 13, 2023. Youth Risk Behavior Survey 2011-2021. Retrieved February 27, 2023 from https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf.
Diana Lambert. February 13, 2023. Violence against teen girls on the rise, so are their feelings of hopelessness. EdSource. Retrieved February 27, 2023 from https://edsource.org/updates/violence-against-teen-girls-on-the-rise-so-are-their-feelings-of-hopelessness.
Rhitu Chatterjee. February 13, 2023. Teen girls and LGBTQ+ youth plagued by violence and trauma, survey says. NPR—KQED. Retrieved February 27, 2023 from https://www.npr.org/sections/health-shots/2023/02/13/1156663966/teen-girls-and-lgbtq-youth-plagued-by-violence-and-trauma-survey-says.
Jean M. Twenge. February 14, 2023. Teen girls are facing a mental health epidemic: We're doing nothing about it. Time. Retrieved February 28, 2023 from https://time.com/6255448/teen-girls-mental-health-epidemic-causes/.
American Foundation for Suicide Prevention. February 15, 2023. The CDC's 2021 Youth Risk Behavior Survey signals a call to address the growing mental health crisis among teens. CISION PR Newswire. Retrieved February 28, 2023 from https://www.prnewswire.com/news-releases/the-cdcs-2021-youth-risk-behavior-survey-signals-a-call-to-address-the-growing-mental-health-crisis-among-teens-301747774.html.
Lisa Jarvis. February 16, 2023. CDC report on teen mental health is a red alert. The Washington Post. Retrieved February 27, 2023 from https://www.washingtonpost.com/business/cdc-report-on-teen-mental-health-is-a-red-alert/2023/02/16/8decdcbe-ae24-11ed-b0ba-9f4244c6e5da_story.html.
Donna St. George, Katherine Reynolds Lewis, and Lindsey Bever. February 17, 2023. The crisis in American girlhood. The Washington Post. Retrieved February 27, 2023 from https://www.washingtonpost.com/education/2023/02/17/teen-girls-mental-health-crisis/.
Ross Douthat. February 18, 2023. American teens are really miserable: Why? The New York Times. Retrieved February 28, 2023 from https://www.nytimes.com/2023/02/18/opinion/depression-teen-social.html?smid=nytcore-ios-share&referringSource=articleShare.
Aallyah Wright. February 22, 2023. ‘These kids can’t wait’: The struggle to address the Black youth mental health crisis. Capital B. Retrieved February 28, 2023 from https://capitalbnews.org/student-mental-health-crisis/.
Jean M. Twenge, A. Bell Cooper, Sarah G. Binau , Thomas E. Joiner and Mary E. Duffy. 2019. Age, period, and cohort trends in mood disorder indicators and suicide- related outcomes in a nationally representative dataset, 2005–2017. Journal of Abnormal Psychology. Retrieved February 28, 2023 http://dx.doi.org/10.1037/abn0000410.
Solving the Crisis But Not the Problem
This month the journal Pediatrics published a retrospective analysis of pediatric mental health emergency department follow-up care. The study tracks post-discharge treatment status of 28,000 children aged 6-17 years from January 2018 to June 2019. The study shows that less than 30% of Medicaid¬-enrolled children received follow-up care within a week of an emergency department visit. After 30 days, only 50% had received a follow-up appointment. The rates of timely follow-up were especially poor for Black youth.
The study demonstrates the importance of follow-up care. Mental health services obtained within at least a 30-day window significantly reduced the risk of a return visit within 6 months of discharge.
Click on the links to learn more.
Jennifer A. Hoffmann, Polina Krass, and Jonathan Rodean, et al. February 13, 2023. Follow-up after pediatric mental health emergency visits. Pediatrics. https://doi.org/10.1542/peds.2022-057383.
Lurie Children’s Hospital of Chicago. February 13, 2023. Nearly half of children on Medicaid lack outpatient follow-up within a month after emergency care for mental health. Retrieved February 23, 2023 from https://www.luriechildrens.org/en/news-stories/nearly-half-of-children-on-medicaid-lack-outpatient-follow-up-within-a-month-after-emergency-care-for-mental-health/.
Marcia Frellick. February 10, 2023. Mental health system failing kids leaving ED. Medscape. Retrieved February 23, 2023 from https://www.medscape.com/viewarticle/988147?src=wnl_edit_tpal&uac=409113PG&impID=5158791&faf=1.
Newsom’s 2023-2024 Budget Proposal Reflects Net Decrease For Child Welfare
On February 22, the California Legislative Analyst’s Office (LAO) issued a summary and analysis of the child welfare provisions in Governor Newsom’s 2023-24 budget proposal. Compared to the revised 2022-23 budget, the LAO says that this year’s budget proposal reflects a $420 million General Fund ($270 million total funds) decrease in the Department of Social Services child welfare programs. Expiration of one-time/limited term funding augmentations are responsible for a large proportion of the net reduction, most notably a $150 million General Fund ($308 million total funds) decrease in the Excellence in Family Finding and Engagement block grants to help foster youth stay connected to family.
The Governor’s budget contains one new child welfare proposal — allocation of $314 million General Fund (dispersed over 5 years; $10.6 million General Fund in 2023-24) for the California Behavioral Health Community-Based Continuum Demonstration, which includes support for early intervention services to help reduce involvement in the child welfare system.
Click on the link below to learn more.
Gabriel Petek. February 22, 2023. The 2023-24 Budget: Analysis of child welfare proposals and implementation updates. California Legislative Analyst’s Office. Retrieved February 28, 2023 from https://lao.ca.gov/reports/2023/4698/Child-Welfare-Proposals-022223.pdf.
Year 1: A Bumpy Roll-Out Of CalAIM Mental Health Initiatives
CalMatters investigative reporters Jocelyn Weiner and Kristen Wang examined the first year of California’s ambitious plan to transform and strengthen Medi-Cal under California Advancing and Innovating Medi-Cal or CalAIM. A key goal of CalAIM is to improve the availability of mental health care for youth. While the new plan is widely applauded by youth mental health advocates, many of those interviewed by CalMatters worry that workforce shortages, provider burnout, and the escalating need for services make this a “tricky time” to launch the initiative.
Compounding these challenges are potential delays in some CalAIM behavioral health investments due to efforts to rein in a projected $22 billion budget deficient. In an interview with CalMatters, Adrienne Shilton, director of public policy for the nonprofit California Alliance of Child and Family Services, said providers are panicked over Governor Newsom’s budget proposal for FY2023-24. On February 1, the California Alliance and the California County Behavioral Health Directors Association sent a letter to legislators expressing specific concern about a potential delay of grants supporting the Behavioral Health Continuum Infrastructure Program, which aims to fund construction and renovation of behavioral health facilities.
The CalMatters article points to other funding problems, citing research conducted by Young Minds Advocacy (YMA) that demonstrates great disparity in Specialty Mental Health Services (SMHS) funding allocations across counties. YMA’s research shows that sixteen medium and large counties, serving more than a third of California’s youth, missed out on $3 billion in mental health funds and failed to serve about ½ million youths since 2011 Realignment. In FY 2019-20 alone, YMA estimates that at least 46,000 youths failed to receive SMHS due to disproportionate 2011 Realignment funding.
Click on the links below to learn more.
Jocelyn Wiener and Kristen Hwang. February 2, 2023. Will the state’s big Medi-Cal plan really fix mental health care for low-income Californians? CalMatters. Retrieved February 20, 2023 from https://calmatters.org/mental-health/2023/02/medi-cal-mental-health/.
Patrick Gardner. November 2022. Disproportionate funding denies specialty mental health care to hundreds of thousands of California youths. Young Minds Advocacy. https://www.ymadvocacy.org/young-minds-pubs-and-presentations.
More Stories in February: Risks and rewards of demographic data collection: How effective data privacy can promote health equity National Health Law Program — 02.01.2023; Let teenagers sleep Scientific American — 02.01.2023; Scrap school police and add counselors and academic help for Black students, coalition says LA Times —02.01.2023; Innovative intervention addresses youth suicide risk in the juvenile justice system Columbia University Department of Psychiatry — 02.01.2023; Feds say cyberattack caused suicide helpline’s outage AP News —02.01.2023; LA County to offer telehealth therapy to all 1.3 million public school students Los Angeles Daily News — 02.01.2023; Surgeon General: Kids under 14 should not use social media Education Week — 02.02.2023; What one educator's grief reveals about the mental health challenges facing teachers now The 74 — 02.04.2023; Strengthening youth mental health by building awareness and reducing stigma National Governors Association — 02.06.2023; Unmet needs: Critics cite failures in health care for vulnerable foster children Youth Today — 0.2.06.2023; Biden calls for more mental health care at schools in State of the Union Education Week — 0.2.07.2023; Seen and served: how dedicated federal funding supports the identification of students experiencing homelessness School House Connection — 02.07.2023; The education of children and youth experiencing homelessness: current trends, challenges, and needs School House Connection —.02.07.2023; How educators secretly remove students with disabilities from school New York Times — 02.09.2023; With therapists in short supply, college students counsel each other The Wall Street Journal — 02.12.2023; Building the future behavioral health workforce: Needs assessment County Behavioral Health Directors Association — 02.13.2023; It takes a village: Foster program is a new model of care for indigenous children KHN — 02.14.2023; Obstacles to mental health access top Californian’s list of health concerns, new survey shows MindSite News — 02.16.2023; Research on teen social media use has a racial bias – studies of white kids are widely taken to be universal The Conversation — 02.20.2023; New proposed regulation would remove barriers for foster families Spectrum News1 — 02.22.2023; Taking a look at 988 suicide & crisis lifeline implementation KFF — 02.28.2023;
