The U.S. mental health crisis is real. However, so is our opportunity to meet it. As Congress races to fund the government ahead of the holidays, it is imperative that it does not forget our nation’s youth.
Recent data from the Centers for Disease Control and Prevention show that 40% of high school students reported persistently poor mental health, with 20% seriously considering suicide. Half of all mental health patients experience their first symptoms by age 14, and three-quarters by age 25. Depression, anxiety, eating disorders, substance use disorders, attention disorders, and post-traumatic stress disorders often begin in childhood.
However, there’s an 11-year delay between symptom onset and treatment for mental illness. Early detection dramatically improves recovery, but our current health system isn’t set up for it. A scarcity of mental health providers means that parents face extreme waitlists, long drives, and high costs. A 2019 report published by Milliman found children’s use of out-of-network mental health office visits is 10 times higher than for primary care, presumably because there are no available in-network providers. These barriers mean many children never receive care for their mental health.
We have a solution, one that’s worked before. Believe it or not, in the 1980s, people in the United States suffering from heart disease generally did not receive any care until after they had a heart attack. Since then, the wholesale reimagination of cardiology, from an exclusively reactionary to a preventative-minded field, has been so complete that people under age 50 have never known a time when poor diet, smoking, lack of exercise, and other lifestyle choices weren’t universally understood risk factors in heart disease.
Not coincidentally, between 1980 and 2000, heart disease mortality in the U.S. was cut in half. What fueled this critical turnaround? Early intervention in primary care.
We need the same shift for mental health. Youth is when mental health conditions can do their worst — and when treatment can do its best. Texas is leading the way.
The state is scaling an early intervention approach called the Collaborative Care Model in health systems, currently reaching 5.8 million adults and children. This evidence-based early intervention approach can improve remission time for depression sevenfold.
The Collaborative Care Model integrates primary care with mental health treatment. A care manager coordinates treatment, freeing up the physician’s time to focus on patients. This role is often filled by someone with a bachelor’s or associate degree, or even a social worker who also provides counseling. This setup allows the primary care doctor and psychiatrist team to treat eight times more patients than in traditional one-on-one care, according to research by the Meadows Mental Health Policy Institute, an independent, nonpartisan organization.
Path Forward, a national coalition that combines employer organizations and mental health stakeholders, called for an expansion of the Collaborative Care Model nationally. One such opportunity is a bipartisan bill by Sens. John Cornyn (R-TX) and Catherine Cortez Masto (D-NV). The Connecting Our Medical Providers with Links to Expand Tailored and Effective Care Act would incentivize its takeup within Medicare.
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This is the sort of commonsense, evidence-based solution that we should all support. Just as in cardiology, success requires collaboration among all health system stakeholders: employers, insurers, and health systems. Research and experience show these models work, but they must be scaled nationally. The future of our national mental health emergency among our country’s youth is not an epidemic. It is a choice.
Anna Bobb, MPH, is the executive director of Path Forward, a community of donors and doers working to accelerate solutions for improving access to mental health and substance use care.
This article was originally published at www.washingtonexaminer.com
