Caring for our mental health is important at all stages of life. It is especially pivotal for the youngest, most vulnerable members of our community. Empowering our community with the resources and support available to care for their mental health has proven to have a widespread impact.
The most recent comprehensive national data on mental health status for pediatric members enrolled in Medicaid indicates that the percentage with any diagnosed mental health or neurodevelopmental disorder increased from 10.7% in 2010 to 16.5% in 2019.
While these data are pre-COVID-19, studies have shown significant increases in attention-deficit / hyperactivity disorder, trauma- and stressor-related disorders, anxiety, autism spectrum disorders, and depressive disorders among Medicaid-insured children during this period.
Multiple studies have shown post-COVID-19, the proportion of children with anxiety, depression, and suicidality increased significantly, with 1 in 5 youth now experiencing a mental health disorder.
For California specifically, data from 2014 – 2015 found that 14% of children insured through Medi-Cal had a documented mental health diagnosis. Rates were substantially higher among those with child protection system involvement. With this increase in diagnoses come additional problems with access to needed mental health care.
One positive outcome of the COVID-19 pandemic was the increased ability for health care providers to utilize telemedicine to provide needed care. This is demonstrated by data showing that during the pandemic, overall mental health service use among Medicaid-enrolled children declined by 9.1% from 2019 to 2020, but telepsychiatry visits increased by 829.6%.
Psychiatric and mental health counseling are particularly well-suited for telehealth care and a way to improve upon current access concerns related to these vital services.
Another way to increase mental health care for children is by providing education to primary care providers so they are readily available to provide this care.
One such program is Cal-MAP from UCSF’s Department of Adolescent and Child Psychiatry department. Their mission notes it is “designed to increase timely access to mental health care for youth throughout California's communities, especially in the state’s most underserved and rural areas.”
Cal-MAP employs a team of psychiatrists, psychologists, and social workers to collaborate alongside primary care providers as they support mental and behavioral health concerns in youth up to age 25. In addition to supporting primary care providers, Cal-MAP offers resources for families impacted by mental and behavioral health challenges in the community.
Mobile apps can also provide California youth and families with access to mental health services and support. Launched by the California Department of Health Care Services, there are currently two such apps available, BrightLife Kids and Soluna.
These apps are described as “free, statewide behavioral health platforms that offer children, youth, young adults, and families access to timely, culturally responsive, and confidential mental health support.” The services provided by both BrightLife Kids and Soluna are available to all California families, regardless of income, immigration status, or insurance coverage.
With innovative approaches leveraging telehealth services, collaborative efforts, and technology, there is hope that access to much needed mental health care for our pediatric members is improving. Access issues certainly remain a challenge, particularly in our rural California counties, but together, we are raising awareness, one conversation at a time.
Dr. Jeff Ribordy, a pediatrician, is a regional medical director at Partnership HealthPlan of California. Partnership is a community-based, safety-net health care organization that contracts with the state to administer Medi-Cal benefits. Partnership provides quality care to over 900,000 Medi-Cal members. Starting in Solano County in 1994, Partnership now serves 24 Northern California counties – Butte, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc, Napa, Nevada, Placer, Plumas, Shasta, Sierra, Siskiyou, Solano, Sonoma, Sutter, Tehama, Trinity, Yolo, and Yuba. Learn more about Partnership at PartnershipHP.org.