Three Ways Payers Can Address the Mental Health Crisis Among Children and Teens

Since the early 2000s, rates of anxiety and depressive disorders, substance abuse, and suicide have continuously increased among American children and teens. Since the onset of COVID-19, however, the rates have skyrocketed, especially among minority and underserved populations.

Three esteemed pediatric organizations joined forces in late 2021 to declare a national state of emergency in children’s mental health induced by the pandemic. “We are caring for young people with soaring rates of depression, anxiety, trauma, loneliness, and suicidality that will have lasting impacts on them, their families, and their communities,” said the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association in a joint statement.

To address the fact that the U.S. health system is not set up to optimally support the mental health and wellbeing of children, health organizations “must reimagine how we can prevent, identify, and address mental health challenges,” according to a U.S. Surgeon General advisory on the youth mental health crisis issued in December 2021.

For health plans, this mission is critical, as Prealize predicts an 8.5% increase in under-18 mental health utilization in 2022. The good news is that there are ways in which plans can support prevention and minimize emergency utilization. Here are the top three:

1. Identify and address the mental health needs of parents, caregivers, and other family members.
   A child’s health depends greatly on parents and caregivers—those who serve as a child’s first guides and influences. The CDC reports that one in 14 children aged 0-17 has a parent who has reported poor mental health. Those children are more likely to have a mental, emotional, or developmental disability and poorer general health.
   
   The Surgeon General’s advisory suggests screening parents and caregivers for depression, partner violence, substance use, and other challenges that are frequently combined with broader assessments of food insecurity, housing instability, and other social determinants of health, then implementing proactive outreach.
   
   
2. Invest in equitable prevention.
   The Surgeon General recommends continuing to prioritize interventions that address social and economic factors that are known to affect children’s health and mental development, including poverty, discrimination, and inequality. Payers can use evidence-based services to assess an intervention’s scalability and support implementation at a community level.
   
   Plans can also use their formidable memberships and data pools to lobby local and federal agencies to ensure that all children and youth have access to comprehensive, affordable mental health care.
   
   
3. Don’t wait for a crisis: Be proactive.
   “We should not have to wait for a teenager to show up in the ER in crisis,” states Ryan Panchadsaram, Advisor to the Chairman of Kleiner Perkins, in Prealize’s State of Health Report 2022: The Domino Effect. “Tools are available to precisely predict this risk and engage sooner with the right care.”
   
   In particular, predictive analytics can help health plans identify at-risk members earlier and enable case managers to intervene up to 12 months sooner for mental and behavioral health issues.

For more ways to improve healthcare for members, read Prealize’s State of Health Report 2022: The Domino Effect. Based on an analysis of 2021 claims data, the report identifies the top health conditions and utilization spikes that industry leaders should act on this year.