On April 28, the Senate Health, Education, Labor and Pensions Subcommittee on Substance Abuse and Mental Health Services held a hearing entitled, “Mental Health in Children and Youth: Issues Throughout Development.”
In his opening remarks, Chair Mike DeWine (R-OH) stated, “The simple fact is that children and youth with emotional and behavioral needs face tremendous challenges to receiving care in our Nation today. Mental health care is dispersed across many systems for children, including schools, the juvenile justice system, the child welfare system, the substance abuse treatment system, through their primary care providers, and within their own families.”
Arguing that the nation has “failed” children with mental illness, Sen. Jack Reed (D-RI) said that the “lack of competent providers combined with limited outpatient mental health services, few substance abuse treatment programs, and virtually non-existent residential treatment facilities, has left families with no where to turn. With few options at hand to access treatment, some parents are even forced to give up custody of their children just to qualify for public mental health programs.”
Dr. Joy Osofsky of ZERO TO THREE said that early relationships and attachments to a primary caregiver “are the most consistent and enduring influence on social and emotional development for young children.” She explained that some infants and toddlers could experience mental health problems if they are exposed to repeated violence, fear and stress, prenatal substance abuse or were born premature or with low birthweight. “In babies and toddlers,” she stated, “the effects of these factors may look like excessive and inconsolable crying; a heightened sensitivity to touch and cuddling; excessive biting, kicking and hitting; inability to focus on activities, flat effect (no expression, no emotion) and depression.” Dr. Osofsky also noted that parents’ mental health could affect young children, stating, “Infants of mothers who have severe chronic, untreated depression often withdrew, ultimately affecting their language skills, as well as physical and cognitive development. Older children of depressed mothers show poor self-control, aggression, poor peer relationships, and difficulty in school.”
Dr. Ofosky suggested that all infant and early childhood services be strengthened and integrated into all child-related services systems; all professionals who have contact with infants and toddlers should have training in early identification of, and intervention for, mental health problems and disorders; investments should be made in a strong infant mental health workforce; and comprehensive mental health services should be provided for infants and toddlers in foster care. She also recommended that Congress should address the mental health needs of infants, toddlers, and their families in reauthorizing Head Start, the Individuals with Disabilities Education Act, the Child Care Development Block Grant, and the Substance Abuse and Mental Health Services Administration.
Testifying on behalf of the Los Angeles Unified School District, Marleen Wong explained that schools “have become the de facto primary source of mental health services for children.” She warned that just establishing school-based mental health services might not be enough to help children, but that the services must be supported with quality assurance and accountability measures. In addition, “Mental health services in schools cannot operate outside the structure and organization of the educational environment,” she stated. “Outcomes must include not only a decrease of symptoms but also evidence of improved academic functioning better grades, improved classroom behavior, fewer absences, and increased attendance.”
Dr. Louise Douce of the Ohio State University, said that between 1975 and 1995 “colleges and university counseling centers saw a dramatic increase in both the numbers and severity of mental health concerns.” She noted that suicide is the second leading cause of death among college students. Additionally, she pointed to a dramatic rise in the number of college students participating in binge drinking, including a 10 percent increase for women, students of color, students of legal drinking age, and seniors. Dr. Douce voiced her support for the Campus Care Act (S. 2215), which would authorize $10 million to increase and enhance mental and behavioral health services available to college students. “This bill will help thousands of students get the help they need when they need it and better insure the return in our nation’s investment in them,” she concluded.
Addressing the problem of young adults as they age out of the adolescent mental health system, Maryann Davis of the University of Massachusetts, stated, “According to child mental health lead administrators, no state is able to address the comprehensive transition-support needs of adolescents in state mental health services beyond the age of 22.” She argued that parents need to be more involved in a child’s transition to the adult system, but they need training and support from mental health care professionals. Ms. Davis also said that more funding “is needed in two basic domains: the development and dissemination of knowledge (how to serve and treat the population), and the funding of services and individuals (making sure that services are available and that those who need them can access them).”
The committee also heard testimony from two mothers whose children suffer from mental illness. Explaining that her family “faced a system that had services fragmented over several child-serving agencies with, historically, no real financial or systemic incentives to collaborate or form partnerships to serve the needs of children and adolescents with mental illnesses and their families,” she offered a number of suggestions for the committee, including: 1) End the discriminatory caps on private insurance coverage for mental health services by passing the Senator Paul Wellstone Mental Health Equitable Treatment Act (S. 486); 2) End the practice of forcing families to give up custody of their child to access mental health services by passing the Keeping Families Together Act (S. 1704); 3) Encourage states to develop effective interagency collaboration and partnerships between all child-serving agencies and with families; 4) Train and educate all child-serving professionals about the early warning signs of mental illness in children; 5) Build an effective children’s mental health treatment system; and 6) Provide parents with appropriate information about their child’s diagnosis and treatment.
