On Nov. 30, the Senate Health, Education, Labor, and Pensions (HELP) Subcommittee on Children and Families held a hearing titled “Caring for Our Kids: Supporting Mental Health in the Transition From High School to College.” This hearing focused on opportunities to strengthen access to mental health services and support young people with mental health conditions as they progress into higher education.
In his opening statement, subcommittee Chair Bob Casey (D-Pa.) outlined the emergent mental health crisis facing the nation’s children and youth, noting, “When pediatric emergency departments across the country are overwhelmed with children in need of mental health care, it is a cry for help.”
During the hearing, Casey emphasized his support for the Investing in Kids’ Mental Health Now Act (S. 4747), which he introduced with Sen. Robert Portman (R-Ohio). This legislation would encourage states to increase Medicaid reimbursement rates for pediatric mental health services through an enhanced federal matching rate. The AAMC recently joined others in a Nov. 29 letter to Casey and Portman urging the inclusion of this bill in a year-end legislative package.
He also highlighted legislation that he and subcommittee Ranking Member Bill Cassidy (R-La.) have introduced to address this crisis, including bills to establish grant programs to expand pediatric mental health providers’ capacity and to streamline disability documentation requirements to help students with mental health conditions navigate the transition from high school to college.
Cassidy likewise outlined the profound toll of the COVID-19 pandemic on the mental health of children and young people in his opening statement. “Suicide [was the] third leading cause of death among those fifteen to twenty-four in 2021. Mental health emergency room visits increased by 25% in children [and by] 30% in teens in 2020 ... This is more than a statistic, it is our future,” he stated.
The subcommittee heard from Sharon Hoover, PhD, professor of child and adolescent psychiatry at the University of Maryland School of Medicine, co-director of the National Center for School Mental Health, and director of the National Center for Safe and Supportive Schools. During her testimony, Hoover urged the subcommittee to consider upstream approaches to promote the mental health and well-being of children. In addition, she outlined her recommendations to cultivate “comprehensive school mental health systems,” in which the educational and behavioral health sectors partner to provide students with a full continuum of mental health supports. These recommendations included expanding existing health care workforce development programs, maximizing reimbursement for mental health services delivered in school-based settings, and increasing reimbursement and technical assistance to support the provision of tele-behavioral health services in schools.
The subcommittee also heard from Ashley Weiss, DO, MPH, director of medical student education in psychiatry at Tulane University School of Medicine. During her testimony, Weiss discussed the severe psychiatric disorders that can emerge during adolescence, including psychosis, as well as the importance of early detection and treatment. She outlined how gaps in Medicaid and commercial insurance coverage, such as a lack of reimbursement for care coordination services, creates challenges for providers who offer long-term, specialized care for severe mental illness. She also highlighted the need to dispel misconceptions and educate teachers and school-based mental health providers about psychosis.
The AAMC has taken other recent steps to ensure access to mental health and substance use disorder treatment services for children and young people, including joining a Nov. 29 sign-on letter urging for the inclusion of the Mainstreaming Addiction Treatment (MAT) Act of 2021 (S. 445, H.R. 1384) in a year-end package, before the end of the 117th Congress.