Children’s mental health agencies missing opportunities

State children’s mental health agencies are failing to capitalize on opportunities to improve their standard of care because of inadequate structures and poor organization, according to a survey of 48 mental health directors published in the latest issue of The Journal of Behavioral Health Services & Research.

The directors surveyed represent 46 states, one territory and Washington, D.C. Given high turnover rates and frequent reorganization efforts, simply finding the director of children’s mental health services in each state was challenging at times, says study author Mario Hernandez, PhD, of the University of South Florida.

Once they were identified and surveyed, the directors’ concerns fell into three main areas:

Workforce shortages. Respondents noted a lack of highly qualified caregivers in the public sector and challenges in retaining top staff because of insufficient financing and limited opportunities for career advancement. Not surprisingly, workforce shortages have in turn led to insufficient service offerings in many areas.

Service accessibility. Medicaid-eligible families have access to a wider array of children’s mental health services, as out-of-pocket costs for privately insured families make such services cost prohibitive, according to the survey. Related, 81% of respondents perceived opportunities to improve accessibility and availability of services through two methods of reform: an expansion of Medicaid eligibility and the inclusion of mental health services as an essential health benefit on private plans.

Shame and stigma. Early detection and treatment have proven to be especially helpful for children with mental illnesses, according to the study’s researchers, but parents feeling shame and a sense of responsibility often proves to be a roadblock. Increased public awareness and understanding about mental illnesses are critical to increasing access to services, said the directors surveyed.

Hernandez credits the Substance Abuse and Mental Health Administration’s Children’s Mental Health Initiative (CMHI) for providing a wealth of knowledge that can be applied at the local level, and says it is key for state leadership to act as a bridge that maximizes resources states do have to work with.

“You have all these unbelievable ideas and all this research and all this demonstration that has been going on for 20 years or more, but you have to have somebody in the state you can hand this pot of gold to,” Hernandez says. “If people in state roles are not there, who’s going to take all this knowledge and expand the concept pretty unanimously identified as the most important thing to use as their compass to navigate all these changes in healthcare and keep children’s mental health in focus and do the things we know work?”