Tackling Children's Mental Health Needs, Step-by-Step

I'm a pragmatic optimist. Why? Because I've seen what can happen when people roll up their sleeves and do the hard work of making needed changes. Things often get better.

This is certainly true for individual children. At Children's Law Center, I've had the luxury of knowing so many great kids who were once labelled "problems" because of their classroom outbursts. These are kids who were throwing desks and chairs, on the road to dropping out - until they got the individualized support and counseling they needed to focus and learn. I've seen so many "problem" kids became good students, good peers and wonderful adults. With the right help.

Just as I know an individual child's life can be transformed, so too can our schools, our government agencies and the District at large.

That's the message I want to send you as I mark this year's Children's Mental Health Awareness Day on May 5. Things are getting better, bit-by-bit, for DC's children with mental health needs. Specifically, they are better in the areas where the leaders and agencies responsible for mental health have decided to roll up their sleeves and get the work done.

It's not just my opinion. Children's Law Center has been formally tracking the DC government's progress and shortfalls in meeting children's mental health needs for five years. The numbers are moving in the right direction, as our 2016 update on children's mental health shows.

The good news is that DC agencies have connected thousands more children to mental health treatment since we first started tracking in 2012.

This progress is primarily the result of the DC government's increased oversight of its network of Medicaid managed-care organizations, which provide a wide range of health care services to the majority of low-income children in DC. These healthcare agencies are providing mental health services to more children in DC than ever before. As a result, about 13,000 children received mental health services last year - a 55% increase since we started tracking this number.

DC is also getting creative about how to identify children's mental health needs sooner and how to meet those needs despite a nation-wide shortage of child psychiatrists. How? By giving pediatricians the tools to fill the gap.

Two new initiatives have expanded the ability of pediatricians to screen and treat children's mental health concerns. Pediatricians caring for low-income children have been trained to identify mental health issues and incentivized to screen more children, thanks to changes in Medicaid billing. Once an issue is identified, the new DC-MAP program gives pediatricians access to an on-call network of mental health experts. This allows pediatricians to treat low-level mental health needs rather than keeping a child waiting during the often lengthy time it takes to get an appointment with a specialized mental health professional.

Taken together, these positive steps are moving DC's mental health system in the right direction for children. The progress demonstrates the DC government can fix seemingly intractable problems when it puts its mind - and its money - to it.

Before you accuse me of being overly optimistic, let me say that I'm also a realist. There is still a steep climb ahead for DC to meet the mental health needs of all our children.

From my work at Children's Law Center, I have an on-the-ground view of how difficult it can be for children to get the specific help they need. I have seen what happens when a young child recovering from violence and abuse doesn't have access to timely counseling. Or when a teen with an anxiety disorder can't get appropriate medication. These conditions, if left untreated, can have lifelong consequences.

Unfortunately, the DC Department of Behavioral Health estimates about 20,000 children in DC are likely to have a diagnosable mental health issue that requires treatment - but we are only reaching 13,000. That's potentially a large gap. And the DC government's own reporting shows that most children still wait far too long to get treatment, and the overall quality of those services is still poor.

All DC children - and especially those who are growing up exposed to violence, family instability, homelessness and poverty - need access to a full range of timely, quality and appropriate mental health interventions if we want them to succeed.

The Mayor and our agencies that provide most of the mental health services to low-income children - the Department of Behavioral Health, Department of Health Care Finance and the DC Public Schools - have much more work to do to achieve this goal.

There's no time to waste. DC needs to keep moving forward with urgency. Our recent progress proves we can get there.

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