State lawmakers prepare proposals to improve children mental health care

Oregon lawmakers are working on bills ahead of the 2023 legislative session to help the tens of thousands of children who are suffering with mental health issues. 

State Sen. Sara Gelser Blouin, who leads the Senate mental health committee, told the Capital Chronicle she’s working on legislation to improve access to mental health services by bolstering the Student Success Act. The 2019 bill invests $2 billion in public schools every two years, and a portion of that money is dedicated to funding school-based mental health services. 

But a majority of students were moved to online learning during the first year of the pandemic which severely hampered the roll out of those new services. 

Gelser Blouin said she wants to pass laws that help the Oregon Education Department administer those dollars effectively to prevent mental health crises and provide greater access to vulnerable children. 

“We certainly have had a significant struggle with getting services to kids that are in crisis, or have very significant complex behavioral health needs,” Gelser Bouin said. “Part of the issue is that it’s very difficult for kids to get the support they need earlier on before something becomes a crisis. There’s a whole series of causes of that, from adequacy of the provider network to reimbursements from commercial insurance.”

Gelser Blouin said she’s focused on proposals that would stem youth suicides and fight bullying and racism. She’d also like children to receive in-patient care that lasts longer than 14 days, which is a typical cap imposed by private insurers. Gelser Blouin said children also need better access to mental health care outside of school so they don’t end up in emergency rooms, which are ill-equipped to handle mental health issues. One proposal that could become law in 2023 would give children greater access to in-patient treatment and therapy by supplementing their insurance to prevent carriers from denying care. 

The push to improve access to mental health care coincides with the release of a study released last week showing that children in Oregon are experiencing depression and anxiety at a higher rate than the national average. 

“Young people in Oregon and nationwide are struggling with anxiety and depression at unprecedented levels,” Our Children Oregon, a Portland-based nonprofit that released its own analysis on Oregon children, said in a statement. 

The “2022 Kids Count” was commissioned by the Annie E. Casey Foundation, a philanthropy in Baltimore, Maryland involved in supporting initiatives to help children. The study looked at four areas – well-being, education, health and family and community – to determine how kids in each state were faring. The report is based on data fromsurveys by the U.S. Census Bureau. 

The report ranked Oregon, which has 860,000 children, 26 overall among the 50 states. It shows the state made progress between 2016 and 2020: Fewer kids were living in poverty and with parents lacking secure employment and more high schoolers graduated on time.

“Pre-pandemic, a lot of important new policies in Oregon, given our politics, have led to improvement in different social outcomes and services in a way that other states don’t implement and invest in the same way,” said Jyoni Tetsurō Shuler, research manager at Our Children Oregon.

But in many areas, children fared worse in 2020. Teen deaths rose and a higher share were obese. Oregon also ranks dismally in educational achievement at 41 of 50.  In 2019 — the last year for which educational data was used in the study — two-thirds of Oregon’s third-graders were not proficient in reading, and 70% of eighth graders were not proficient in math. Those figures were even higher among racial and ethnic minorities: 83% of Hispanic third-graders were not proficient in reading, and nearly 90% of Native American eighth-graders were not proficient in math. 

The number of Oregon children struggling with anxiety and depression also rose – from 11% in 2016 to 16% in 2020, a 40% increase from 83,000 to 117,000 kids. 

Nationally, nearly 12% of children — approximately 1.5 million — experienced anxiety and depression in 2020, up from 9.4% in 2016. The study attributes this increase partially to educational disruption the first year of the pandemic.

Shuler said the study indicates that many children suffering from anxiety and depression lack access to counseling services. But economic factors such as a lack of food and stable housing also cause mental health stress, Shuler said. The study ranked Oregon 30 out of 50 in the economic well-being of its children. Oregonians of color and rural communities suffer the worst, Shuler said. 

“In rural parts of our state and where there’s a large concentration of BIPOC youth, there are significant disparities that are systemic,” Shuler said, referring to Black residents, indigenous and people of color. “We’re talking about a lack of investment and about systems that have been in existence for enough time now that we’re still seeing you in certain areas not thriving and not being able to access the right resources.” 

Nearly one-third of kids in Douglas, Yamhill, Crook and Jackson counties reported lacking access to counseling. In Coos, Grant and Lincoln counties, nearly one-quarter of children do not have enough nutritious food. 

In Wheeler, Malheur, Harney, Coos and Curry counties, between one-fifth and one-quarter of all children live in households under the federal poverty line –  $13,590 in annual income for one person or $27,750 for a family of four. 

The report showed that half of families with children in Oregon face high housing costs, accounting for one-third of their income. 

And while 3.6% of families with children statewide reported unstable housing situations, that percentage doubled for Black and Native American families in 2020. 

“Housing is one data point that reflects how these issues are multi-pronged,” Shuler said. “There are many facets involved in the larger economic systems at play,” including exorbitant housing costs, displacement due to natural disasters like wildfires and food insecurity. 

Schuler said that the Oregon Legislature’s focus on increasing spending on mental health care and substance abuse gives her hope that conditions will continue to improve for the state’s children. 

Gelser Blouin said one area in which the state needs major improvement is in providing continuing care, not just at one point in time. 

“We’ve never really created the systems to support people after they get through the crisis,” she said. “We can build beds forever, but until we actually invest in community services, and recognize that people experiencing mental illness need support and wraparound services for a lifetime to continue to thrive, we’re going to just keep being stuck in a crisis.”

Source: https://oregoncapitalchronicle.com/2022/08/16/state-lawmakers-prepare-proposals-to-improve-children-mental-health-care/