Children’s Mental Health Campaign

by Boston Children's Hospital staff on May 9, 2012

David DeMaso, MD

National Children’s Mental Health Awareness Week is May 6 though 12. In honor of the occasion David R. DeMaso, MD, psychiatrist-in-chief at Boston Children’s Hospital, addresses the work of the Children’s Mental Health Campaign in Massachusetts.

What is the state of children’s mental health in the Commonwealth?

The good news is that we’ve come a long way. Massachusetts is a national leader in children’s mental health. Since 2006, when Boston Children’s and Massachusetts Society for the Prevention of Cruelty to Children (MSPCC) released a joint report on children’s mental health, children are now more likely to receive timely care, delivered in the right setting, than six years ago. However, the system continues to be fragmented, which creates barriers to care. We still need to take important steps to expand access to effective, high quality and well-coordinated care for all children with mental health needs.

What is the Children’s Mental Health Campaign? What have been the most significant achievements of the Campaign to date?

Launched by Boston Children’s and the MSPCC, the Campaign also includes the following founding partners –Health Care for All, Health Law Advocates and the Parent Advocacy League. Since 2006 it has grown into a diverse coalition of more than 140 organizations with expertise in mental health, healthcare, law, child welfare, family advocacy and policy—all working together to advocate for systemic change of the children’s health care system.

Through the Campaign’s efforts, the landscape for children’s mental health in the Commonwealth has changed significantly. Three landmark laws have been enacted: the Children’s Mental Health Omnibus law of 2008, the Mental Health Parity reform law of 2008 and the Autism law of 2010.

These laws have improved access to care, spurned early identification of children with mental health needs, highlighted the importance of increasing schools’ capacity to address the mental health needs of students, expanded insurance coverage for children in need of mental healthcare services and reduced by more than 60 percent the number of kids “stuck” in inappropriate care settings.

What are the biggest remaining challenges?

The Second Children’s Mental Health Summit, hosted last December by the Campaign and the Boston Bar Association and attended by over 200 leaders, identified four major needs in the children’s mental healthcare system that are still unmet: mental health parity reform, payment reform, education and mental health and juvenile justice and mental health. Questions about how we pay for mental health services, eliminate the stigma attached to mental health and ensure equal protection of children with mental health needs, promote early detection and treatment of mental health problems in children, and develop strategies to keep children with mental health needs out of the juvenile justice system are important issues that we need to address. Workgroups have or are being formed around these priority areas.

What are the biggest priorities of the Campaign moving forward?

Currently, we are working to pass more reform laws. The most pressing are:

1. Massachusetts Child Psychiatry Access Project (MCPAP) MCPAP is a system of regional children’s mental health consultation teams designed to help primary care providers (PCPs) meet the needs of children with psychiatric problems. While MCPAP is currently funded 100 percent by the state, 67 percent of the users are commercially insured children. A bill has been filed (S.B.1960 and H.B. 1416) that would require commercial insurers to pay their fair share in the operation of MCPAP.

2. CHINS reform: Families and Children Engaged in Services (FACES) Legislation has also been introduced (S.B. 1963 and H.B. 3492) which would replace the failing Children in Need of Services (CHINS) system with a new Families and Children Engaged in Services (FACES) system. FACES would create a statewide system of community-based preventive services that would help keep kids in their homes and schools and avoid using the courts, police and probation to solve family issues. The current system is especially problematic for the more than 50 percent of CHINS-involved youth with mental illness, who need access to treatment and support to help them build strong connections with their families and communities.

3. Safe and supportive schools Research shows that safe and supportive school environments are a necessary foundation for improving educational outcomes for all students. Legislation introduced this session (H.B. 1962) requires all schools to develop action plans for creating safe and supportive schools by 2017 and provides schools with the organizational tools to align the many student support initiatives, such as: bullying prevention, drop-out prevention, truancy reduction, trauma sensitive environments and social/emotional learning.

Please refer to www.childrensMentalHealthCampaign.org for more information on all the Campaign legislative, budget and regulatory actions.

Stay posted for progress on these bills and for our call to action for children’s mental health in the upcoming Senate budget, expected to be released May 23rd, 2012. If you are interested in joining the Campaign, please contact karen.darcy@childrens.harvard.edu.

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