It’s time to fully address Florida’s pediatric mental health crisis

For many children and families, what began as a public health emergency turned into a mental health crisis. The duration of the pandemic, isolation from friends and family, effects of parental stress and economic hardship, and loss of loved ones take their toll on children’s mental health.

 On Dec. 7, 2021, citing mounting evidence of ongoing harm, U.S. Surgeon General Vivek H. Murthy issued a public health advisory on the mental health challenges confronting youth, a rare warning and call to action to address an emerging crisis exacerbated by the pandemic.

It will require short-term investments to acutely ameliorate the pediatric mental/emotional/behavior health crisis now being experienced by our children’s hospitals emergency departments and our families, AND a longer- term process to better understand the local and regional problems, to create structures to ask and answer problems, and a system to fund programs and analyze outcomes. The differences across communities, urban vs. rural settings, and to coordinate with local resources and institutions, will require targeted and varied approaches.

FACH recommends that the Florida legislature appropriate at least $75-million, using currently undesignated funds from the CARES Act, other Federal initiatives, and state surpluses, to support a grant program that will:

  • define the scope of mental/emotional/behavioral (MEB) health needs across regions of the state
  • evaluate modifications of existing mental/emotional/behavioral resources and networks and determine areas for improved efficiency
  • evaluate innovative solutions using telehealth, tiered levels of intervention, and novel intervention strategies that can be taken to scale once shown to be effective
  • support expansion of training programs to address a statewide workforce shortage in mental/emotional/behavioral health providers at every level.

 

Solutions for Florida’s Pediatric Mental  Health System

Infrastructure Development

Florida allows hospitals flexibility in psych beds to allow reimbursement as patients are stabilized. The build-out of additional psych beds is also needed in many communities. Short term non-recurring infrastructure dollars could be used for this effort as well as to support the addition of step-down services and crisis stabilization units.

Evaluation & Expansion of Effective Telehealth Services

Florida allows for the flexibility of telehealth services with appropriate reimbursement. While it might seem counterintuitive, remote therapy has improved engagement, mitigated symptoms and reduced repeated hospitalizations among an especially vulnerable population of teens and young adults. Researchers attribute the success of virtual treatment largely to the elimination of transportation as a barrier to clinical care. They also noted that telehealth enabled clinicians to learn more about patients, meet family members, get to know patients’ physical environments and observe patients’ moods in their home settings. And, no surprise, youth tend to be more comfortable with telehealth services.

Statewide Needs and Resource Assessment

A statewide assessment will provide  solid data on staffing and capacity issues that lead to a comprehensive plan to address service needs.

Florida Pediatric Mental Health Advisory Council

Establishing a Florida Pediatric Mental Health Advisory Council Council could help advise on the issues that will need to be addressed in improving the MEB system for youth, as well as provide some coordination and oversight. 

Innovative Models of Training for Workforce Expansion

Florida must expand mental health training programs, and develop and implement residencies and fellowships to increase the workforce. Increasing the child mental/behavioral health workforce – including licensed clinical child and adolescent psychologists, pediatric psychologists, pediatric neuropsychologists, and developmental and behavioral pediatricians – would help address the shortage in Florida. The state also can expand capacity by recruiting service extenders, such as child psychiatric nurses, Licensed Clinical Mental Health Counselors and Licensed Clinical Social Workers. Creating a network of pediatric-specific practitioners would make mental health services available when a child is most in need and minimize the onerous wait times families now experience trying to access these services, especially if linked to a robust telehealth system reaching underserved areas such as Florida’s panhandle.