A budget revision released in May by Gov. Gavin Newsom could put more than $4 billion toward home visiting programs, school counselors, childhood trauma screenings and better Medi-Cal coverage for psychiatric care.
Advocates say this is a substantial increase in funding for child mental health, and clinicians say it’s needed, especially given stresses that have arisen during the COVID-19 pandemic.
The California Children’s Hospital Association found that two thirds of children with mental health needs don’t receive care, due in part to a lack of available providers. There are only 13 certified child and adolescent psychiatrists for every 100,000 children in the state, according to the group’s report.
At a recent forum about the proposal, Marika Collins with Casa Pacifica Centers For Children and Families on the central coast said that funding challenges make it difficult to hire and train people who can provide on-the-ground mental health services.
“We’ve got all of this energy and attention and yet we have a woefully inadequate workforce,” she said. “We’re really in a conundrum, but we’re ready to do the work … to be in the home before school, after school, three in the morning.”
The funding Newsom wants to set aside would expand coverage for one-on-one and group counseling for children on Medi-Cal, the state’s low-income health plan. It would also go toward training more health workers in underserved communities and helping schools hire more nurses, counselors and psychologists. The money could expand home visiting programs, and early childhood trauma screenings.
“This will have a significant interaction with schools in creating the infrastructure, as part of what we do to make sure schools are equipped to be there for their students around emotional and social wellbeing,” said state health and human services secretary Dr. Mark Ghaly at the forum.
Ghaly said California childrens’ hospitals have seen a 35% increase in young people seeking emergency treatment for mental health conditions during the pandemic.
Tam Nguyen, a Sutter Health psychologist who sees both youth and adults, says she’s watched her youngest patients grow more distressed over the course of the pandemic. She says they’re having trouble sleeping, and that they miss their friends and extended family.
“That sort of progressively got worse through the wintertime,” she said.
She says depending on what stage of brain development a child or teen is in, it can be difficult to navigate changes and interpersonal relationships even in a normal year.
“And now we have this national crisis that’s completely turned around the way that they live, work and play,” she said. “It was particularly difficult for many of them to make that real-time adjustment. So what you saw were sometimes impulsive reactions.”
She says that includes children becoming verbally aggressive or withdrawing into isolation.
The Little Hoover Commission, an independent state oversight agency, hosted the forum on the proposal last week to assess the governor’s plan, and the lack of child mental health services statewide. The commission is calling for “more coherent and more cohesive state leadership” over mental health care, including for the state’s youngest residents.
“This proposal has the potential to fundamentally transform California’s child mental health system,” said commision chairman Pedro Nava of the new proposal.
At the commission hearing, attendees from child care centers and other community groups said they’re concerned about suicide risk, and also about the likelihood that children with undiagnosed developmental disorders aren’t getting the help they need. Speakers raised concerns about children who are undocumented or who live in mixed-status homes being less likely to receive care.
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