With every new traumatic shooting that rivets the nation’s attention, mental health becomes a hot topic for debate for a short while before dying down until the next disaster. In an attempt to move the dialogue into action, the National Alliance on Mental Illness, or NAMI, and the Cigna Foundation are hosting an all-day forum on Wednesday, June 4, at George Washington University titled “It’s Time to Take Action: Innovative Community Approaches to Children’s Mental Health.” You can learn more here, and read the following post, which details steps that will move the mental health debate from dialogue to action. It was written by Mary Giliberti and Stuart Lustig. Giliberti is the executive director of the National Alliance on Mental Illness, and Lustig is the lead medical director for child and adolescent care for Cigna Behavioral Health and associate clinical professor at the University of California San Francisco in the Department of Psychiatry.
By Mary Giliberti and Stuart Lustig
Our nation has just witnessed another tragedy involving a young adult, with young adult victims. Facts often emerge slowly and it is important not to speculate about diagnoses through the news media; however, it seems clear in this case that mental illness is a factor—even though few people living with mental illness are violent.
To avoid tragedies, solutions are needed. One area of real promise is early intervention—before crises occur. Mental illnesses are diseases that strike early: the symptoms for approximately 50 percent of lifetime cases appear by age 14 and 75 percent by age 24. It can take as long as eight to 10 years to get people with mental health issues to get the treatment they need.
One in five children struggle with mental health conditions and suicide is the third leading cause of death for people ages 10 to 24. It’s critical that we focus on children and youth who are vulnerable and may face delayed access to mental health treatment.
Despite the increase in public awareness of childhood mental health issues, stigma continues to exist as a barrier to care. During this delayed access, children are missing critical developmental milestones, experiencing school failures, social isolation, family distress, or, in particularly tragic cases, attempting or completing suicide. Families confronting mental illness often do not know where to turn for advice or struggle to find an appropriate and available mental health care provider.
However, amidst the turmoil, there is hope. Many successful, innovative approaches have emerged in pockets of local communities across the country. NAMI and Cigna have identified three key, no-nonsense, cost-effective innovations that should be examined for replication nationwide.
First, we need to ensure that mental health services are available to young people where they are every day – in schools. Bringing mental health prevention and early intervention into schools makes perfect sense. School-linked mental health programs make it possible for children and families to receive help in a familiar, non-stigmatized setting where professionals have an opportunity to really know and understand the children they serve. In addition, schools must know how to recognize signs and symptoms early and assist youth and families in getting appropriate help.
Second, addressing the mental health of children in primary care, including screenings, is key to ensuring that children with mental health needs are identified and linked with services. There are many barriers to early identification, intervention and care for young people with mental health conditions including a shortage of mental health services and providers. With the majority of children and youth in the regular care of pediatricians, conversations, as well as effective early identification and treatment should routinely take place in primary care settings with referral to specialty care.
Third, we need to promote intensive, youth-friendly mental health services that effectively engage young people. The National Institute of Mental Health has researched a package of services for youth focusing on employment and education along with family support and treatment. These intensive services get young people with serious mental health conditions on the right track. Mental health crisis services are also needed for those with the most serious conditions.
These solutions leverage what matters most to youth – relationships, school and work—while also recognizing the important role that families and schools play in the lives of children. It’s time to take action to ensure a better future.