California kids are in trouble. Unprecedented levels of toxic stress and trauma resulting from the pandemic have exacerbated a pre-existing crisis in children’s mental health.
Even before the pandemic began, rates of teen suicide and self-harm were on the rise. Now, nearly two years into the pandemic, the social isolation, emotional disconnection, economic stress and physical impact of COVID have taken their toll on our young people and exacerbated an already critical problem.
The Little Hoover Commission, the California government’s independent watchdog, is calling on the state to strengthen its support system for the mental and emotional well-being of children. The state must appoint an accountable leader, set clear goals, encourage coordination, and use schools as key sites to help children. This will ensure that the state uses funds dedicated to the mental and emotional well-being of children effectively and in the way that has the most impact, in the short and long term.
COVID has had a unique piercing impact. This has been a major cause of stress and anxiety as pandemic-related safety measures – including social distancing and remote learning – cut many children off from their usual sources of support.
Chronic stress affects many children’s ability to regulate their emotions and behaviors, to pay attention, and to start and finish tasks. Educators see this firsthand.
As many children returned to in-person learning this fall, school districts reported skyrocketing absenteeism rates and an increase in student misconduct. Worse still, at the start of 2021, ER visits for suspected suicide attempts were almost 51% higher among teenage girls and 4% higher among teenage boys compared to the same time in 2019.
Major national organizations declared a state of emergency for children’s mental health this fall. The US surgeon general released an advisory last month with recommendations to support children amid the mental health crisis.
But California has long struggled to adequately support the mental and emotional well-being of children.
Its child mental health support system faces a host of systemic barriers – including decentralization and workforce shortages – that prevent children from accessing much-needed mental health services. . In 2018, California ranked 48th nationally for providing mental health services to children.
Additionally, access to care is often more difficult for young people from minority and low-income communities, who have also borne the brunt of the effects of the pandemic.
The good news is that Governor Gavin Newsom and the Legislature have taken critical steps to improve California’s child mental health support system. Last year, they created the Child and Youth Behavioral Health Initiative – a $4.4 billion investment in developing a comprehensive mental health care system for Californians from birth to 25 years.
In our report, COVID-19 and Children’s Mental Health, the commission calls for additional reforms to ensure the behavioral health initiative realizes its potential:
First, establish a single point of global leadership for children’s mental health. This statewide leader should be responsible for creating clear plans to coordinate and implement the Child and Youth Behavioral Health Initiative.
Second, set yourself clear results goals. The state should set goals for children’s mental health based on key metrics related to general mental well-being, access to care, and quality of care.
Third, promote coordination around children’s mental health care and services. The state should increase the support and technical assistance it provides to counties, health plans, and other mental health providers. By cultivating a culture around collaboration and support, state and local governments can work better together to advance statewide goals.
Finally, centering schools as sites of support for the mental well-being of children. The state should encourage schools to develop comprehensive plans to coordinate student mental health services, use and share data, and integrate new and existing funding to create sustainable mental wellness programs.
Under California’s current child mental health support system, too many children fall through the cracks. To fully meet the mental health needs of our children, we must first address the gaps in the system – before it’s too late.
Pedro Nava is chairman of the Little Hoover commission. Sean Varner and David Beier are members of the commission’s subcommittee studying the economic recovery from the pandemic. They wrote this comment for CalMatters.