A NEW NATIONAL The report ranked Massachusetts first in the nation for child welfare, but buried in the report is a significant danger sign: Massachusetts is one of the worst in the nation when it comes to rates of depression. and anxiety in children and adolescents.
According to the Annie E Casey Foundation’s Kids Count 2022 data book, based on an analysis of the U.S. government’s National Survey of Children’s Health, 18.4% of Massachusetts children ages 3 to 17 experienced anxiety or depression in 2020, an increase 50.8% compared to 2016, when 12.2% of children suffered from anxiety or depression. . The national average in 2020 was 11.8%.
The figures are estimates based on surveys asking if the child has ever been diagnosed with anxiety or depression by a health care provider.
Only Vermont had a higher rate of pediatric anxiety and depression, 19.2%, and New Hampshire tied with Massachusetts for the second highest rate in the nation. Massachusetts had the seventh highest rate of increase in anxiety and depression between 2016 and 2020, behind South Dakota, California, Arkansas, Washington, DC, South Carolina and USA. Alaska.
Of course, anxiety and depression aren’t the only measures of childhood well-being. Massachusetts ranked first among all states overall, a ranking that includes measures related to health, economic well-being, education, family and community. It fared much better than the national average on the number of children without health insurance, teen births, children living in poverty, and child and adolescent deaths. Of 16 indicators, the only one where Massachusetts fared worse than the national average was in children living in households with a high housing cost burden.
But high rates of mental health problems among children and adolescents present a major problem that state officials and mental health providers say they are already grappling with.
“We are hearing from family members and young people themselves saying that the impact of the pandemic, the closure of schools, the inability to see friends, to socialize, left them alone, isolated, they lacked that social connection,” said Mary McGeown, executive director of the Massachusetts Society for the Prevention of Cruelty to Children and campaign leader for children’s mental health.
One caveat is that advocates say the high ranking may not be all bad — it may mean Massachusetts is better than other states at identifying and treating children with mental health needs.
Danna Mauch, president and CEO of the Massachusetts Association for Mental Health, said Massachusetts has the highest rate of insurance for children, with near universal coverage. (Data from Annie E Casey found that only 1% of Massachusetts children lacked health insurance between 2016 and 2020, compared to 5% nationally.)
Following a sweeping 2006 court ruling, MassHealth is requiring primary care physicians during healthy child visits to include standardized behavioral screening and refer children for treatment if needed. Mauch said MassHealth data shows more than 85% of Medicaid-eligible children undergo annual mental health screenings. Private insurers have also focused in recent years on integrating behavioral health care into primary care, including screening for behavioral health issues.
“There are more opportunities to access services and places where your mental health and well-being will be observed,” Mauch said.
Mauch said there remained issues with timely access to mental health care. But screenings and insurance coverage mean problems are identified, leading to higher reporting rates. “There is significant under-reporting of actual levels in other jurisdictions where children do not have benefits and do not have access to services and therefore are not screened,” Mauch said.
Regardless of state comparisons, advocates say the high rates of reported anxiety and depression are consistent with what they find among providers and families.
“Even before the pandemic, children’s mental health was a crisis in Massachusetts,” McGeown said, citing high levels of anxiety and suicide attempts. The pandemic, she said, has exacerbated these trends.
Particularly in 2020, she said, many children worried about the impact of COVID and the possibility of their parents getting sick. Some older students were trying to manage remote learning while babysitting younger siblings. Social isolation compounded the problems. Children lost access to mental health services that would typically be offered at school.
While many mental health clinicians have switched to telehealth, it’s not always the best way to reach a child. “Providing behavioral health services to a six-year-old child remotely is difficult,” McGeown said. “It’s harder after you’ve been on Zoom all day for school.”
“All of this contributed to young people feeling more anxious and depressed at a time when access to these services was strained and difficult,” McGeown said.
State officials are working to resolve the problem. The Executive Office of Health and Human Services has launched several public awareness campaigns to de-stigmatize conversations about mental health. administration launched a Roadmap for Behavioral Health Reform, which creates a multi-year framework for improving mental health services. The framework makes outpatient assessment and treatment more available, including in primary care settings; create more community urgent care centers for people with mental health crises; and increases the capacity of inpatient psychiatric beds.
A behavioral health hotline is set to launch in January 2023, which would provide round-the-clock access for people to be assessed by a clinician and referred for outpatient treatment at behavioral health centers. communities or seen by a mobile crisis team. The administration recently announced the selection of 25 community behavioral health centers that will provide expanded access to routine, emergency and crisis care starting in January, including same-day, evening and weekend visits and mobile crisis teams. A Behavioral Health Urgent Care program also started earlier this year, which now has providers in 40 sites offering evening and weekend hours and same-day or next-day appointments.
Separately, the House and Senate recently passed a mental health bill, which awaits action from Governor Charlie Baker. Many provisions would help children and adults, such as ensuring parity in insurance coverage for physical and mental health care and guaranteeing coverage for annual mental health wellness exams. The bill addresses long emergency room waits for psychiatric inpatient beds, a particularly acute problem for young people, by creating an online portal where hospital providers can find open beds. The bill also improves the availability of school-based mental health supports, limits the use of suspensions and expulsions for preschoolers, and requires behavioral health assessments and referrals for all foster children. reception.