R.I. KIDS COUNT calls on state to address mental health crisis among children

Updated at 10:35 a.m.

PROVIDENCE – Rhode Island KIDS COUNT on Monday released a new report that calls on the state to immediately address the mental health crisis impacting families, children in particular.

In the 12-page report, titled “Children’s Mental Health in Rhode Island,” co-written by KIDS COUNT policy analysts Kelsey Bala and Kaitlyn Raab, the nonprofit notes that many children were experiencing mental health challenges before the onset of the COVID-19 pandemic, and the pandemic has exacerbated the problem. KIDS COUNT states that both Rhode Island and the U.S. are currently in a “mental health crisis,” and local organizations feel the same way.

In April, the Rhode Island chapter of the American Academy of Pediatrics, the Rhode Island Council of Child and Adolescent Psychiatry, Hasbro Children’s Hospital and Bradley Hospital all declared a state of emergency in child and mental health, stating that mental health and suicide concerns among adolescents are on the rise.

According to the report, about 1 in 5 children in Rhode Island ages 6-17 have a diagnosable mental health problem and 1 in 10 has “significant functional impairment.” Last year, 22% of Rhode Island high school students reported receiving needed help when feeling anxious or depressed, an 11% drop from 2019.

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The survey also noted within KIDS COUNT’s report an upward trend over the last six years of high school students feeling either sad or hopeless. In 2021, 38% of local high school students reported feeling hopeless or sad for more than two weeks. That’s a 6% increase from 2019; a 9% increase from 2017 and a 12% increase from 2015.

Suicide and suicide attempt rates are also a concern to the organization, per the report. Almost 10% of Rhode Island high school students, according to the report, said they attempted suicide “one or more times” during the past year. In 2020, 467 local teams ages 13-19 were admitted to an emergency department after attempting suicide and 334 such teens were hospitalized from suicide attempts. Between 2016 and 2020, 13 youths ages 15-19 committed suicide, 92% of them were male, the report states.

Bala told Providence Business News in an email that 30 of the 38 public school districts across the state have allocated Elementary & Secondary School Emergency Relief Fund money to social-emotional learning, and mental and behavioral health. KIDS COUNT, Bala said, plans to take advantage of recent federal guidance allowing states to expand their school Medicaid programs  to provide a wide array of supports including mental health supports to Medicaid-eligible students and ensure that there is a specific state appropriation for school-based mental health services in order to better provide mental health supports in schools. She also said more mental health professionals need to be hired in schools, as well.

The report also notes that youths who are lesbian, gay, bisexual, transgender or queer are “more likely” to have mental health issues or suicidal ideations than their peers. Such youths who lost access to school-based services due to the pandemic “may have had increased youth mental health needs due to lockdowns in environments where they may not have been supported or accepted,” per the report.

Raab told PBN in an email “systemic changes” are needed to provide the LGBTQ+ community a welcoming environment. Creating a diverse mental health workforce that is “trauma-informed and culturally competent” and “that affirms LGBTQ+ youth’s gender identities and sexual orientations and supports their mental health needs and challenges,” she said.

The state has taken steps to address children’s mental health needs, such as passing the Infant and Early Childhood Mental Wellness and Trauma Informed Schools acts this year, according to the report. The IECMWA requires the state to create a plan to use Medicaid to help improve early identification and treatment of mental health challenges in young children. The TISA requires all school administrators, teachers and staff to receive trauma-informed training to help students have a sense of belonging in schools.

But the report calls for the state to do more. It notes 11 recommendations, including increasing state funding and Medicaid rates for health professionals to help address mental health issues, addressing workforce challenges in children’s mental health such as creating training programs, and increasing implementation and sustainable funding of effective models of school-based mental health care with clinical strategies.

Regarding the Medicaid rates, Raab said the organization recently sent a letter to the R.I. Executive Office of Human Services asking the state agency to include an increase in Medicaid rates for behavioral health services in the budget they submit to the governor for inclusion in the 2024 proposed fiscal budget. KIDS COUNT is “hopeful” the increases are part of that budget, she said.

It is unclear how much money is truly needed to properly address the state’s mental health crisis for all, children included. Bala, though, said the state needs sustainable and long-term strategies for supporting a seamless, coordinated and equitable system of behavioral health care for children in Rhode Island. To do that, she said Rhode Island needs to both optimize the funds that can be drawn down from the federal government though Medicaid and other sources and provide adequate state funding. Bala also said the organization is interested in working with others inside and outside state government on how to best invest in addressing the crisis.

“Our kids can’t wait,” KIDS COUNT Executive Director Elizabeth Burke Bryant said in a statement. “Rhode Island needs to create and invest in a seamless and coordinated behavioral health system of care for children and their families. This system needs to align with and strengthen current systems and provide the right care, at the right time, in the right place and support children as they grow and transition to adults.”

(Update: Comments from Kids Count policy analysts Kelsey Bala and Kaitlyn Raab added in in 7th, 9th, 12th and 13th paragraphs.)

KIDS COUNT representatives did not immediately respond to Providence Business News for additional comment.

James Bessette is the PBN special projects editor, and also covers the nonprofit and education sectors. You may reach him at Bessette@PBN.com. You may also follow him on Twitter at @James_Bessette.