The mental health of children is as important to their overall well-being as their physical health. Research clearly demonstrates that children’s healthy social and emotional development is a critical foundation for learning, school success, healthy relationships, and general well-being and that these foundations are built prior to school entry.[1] Yet the current systems of services supporting children’s social and emotional development place most of their emphasis on treatment.Supporting efforts to bring together a comprehensive, coordinated and integrated children’s mental health system will ensure more children receive the support they need as early as possible.
Assuring that all Illinois children receive needed prevention, intervention and treatment services can save the State money by reducing long term costs associated with children’s and adults’ mental health treatment.[2]Nearly 70% of those in the Illinois juvenile justice system have mental health problems.[3]Half of all serious adult psychiatric illness starts by age 14.[4]Emerging research has shown that early treatment can prevent or even reverse brain changes that are associated with recurring episodes of depression, which if left untreated in childhood will extend into adulthood.[5]The child exposed to violence, trauma, or a parent with depression or other mental health disorder is more likely to develop learning, behavior, or mental health problems himself. Starting early and building more comprehensive children’s mental health services makes fiscal sense.
The numbers of children experiencing mental health problems is large and growing. By 2020, it is estimated that neuro-psychiatric disorders will become one of the top five causes of disability, morbidity and mortality among children in the US and worldwide.[6] FACTS
7.5% of Illinois children ages 3-17 are reported to have moderate or severe social or emotional difficulties. Those children living in poverty are reported to have a rate of 14.6%. [7]
Parent-reported social-emotional problems among 2- and 3-year-olds ranged between 10% and 15% in several studies nationwide.[8]
42% of Illinois childcare programs participating in a survey reported having to ask a family to withdraw a child because staff was unable to manage the child’s behavior.[9]
Only 20% of Illinois children with serious emotional disturbances receive needed care in any given year.[10]
In Illinois, there was a 23.8% increase in children’s hospitalization rates for psychoses from 2000-2004.[11]
Only 16% of psychologists and psychiatrists in Illinois participate in the Medicaid program. [12]
39 counties in Illinois have no psychologist or psychiatrist.[13]
CHALLENGES As indicated above, the major challenge in Illinois’ children’s mental health arena is the growing volume of children in need of services and a system that is unprepared to meet that need. The system limitations are varied.Financial barriers are a major challenge with only 16% of psychologists and psychiatrists taking Medicaid recipients. While there is a workforce shortage throughout the State, some counties, particularly rural counties, have more severe shortages than others. Most children’s mental health service is focused on treatment of the most severe mental illness. Attention needs to be paid to developing capacity to intervene earlier, to assess, diagnose and refer for less severe conditions. Certain populations have more pressing needs than others. Special populations needing attention include the youth who age out of the foster care or juvenile justice systems but who are still in need of counseling and support.
The systems serving children are not integrated. This means that the mental health provider, the child care provider, the school counselor or teacher, the health care provider or even the early intervention provider do not know what services teh other can provide or how to find and then link children to them. This results in families wasting time floundering between systems, duplicate assessments being conducted and children eventually falling through the cracks. There is shortage of trained professionals. A surge is needed in the workforce to create a comprehensive, coordinated children’s mental health system. The workforce in child-serving systems like child care, health care or education, is not trained to provide mental health assessment and diagnosis. They can, however, be trained to conduct simple yet validated screenings to detect problems early and refer children to appropriate services. Additionally, the capacity of the mental health system to provide treatment is limited by dollars to fund staff in general and those trained to serve younger children in particular. Consultation and training within the mental health system is needed, as is an increase in resource funding to serve the newly found children.
[1]Illinois Children’s Mental Health Task Force. Children’s Mental Health: an Urgent Priority for Illinois. Final Report. April 2003.
[2]Centers for Disease Control and Prevention. An Ounce of Prevention… What are the Returns?2nd ed., rev. Atlanta, GA: US Dept. of Health and Human Services. 1999.
[3] Ibid.Illinois Children’s Mental Health Task Force.
[4]New England Journal of Medicine. Uncovering an Epidemic:Screening for Mental Illness in Teens. Friedman, Richard A. M.D. Perspective .355:26. December 28, 2006.
[5]Maternal and Child Health Bureau, Health Resources and Services Administration, US Dept. of Health and Human Services. Children’s Mental Health: Prevention, Early Intervention, and Treatment. Issue Focus.March 10, 2003.
[8]Journal of Child Psychology and Psychiatry. Assessment of young children’s social-emotional development and psychopathology: recent advances and recommendations for practice. Carter, Alice; Briggs, Gowan, Margaret J; Ornstein Davis, Naomi. 45:1 (2004).109-134.
[9]Ibid. Illinois Children’s Mental Health Task Force.