Addressing the Behavioral Health Needs of Children, Adolescents and Young Adults
Experiencing behavioral or mental health symptoms can be alarming, confusing, and exhausting for children, teens, young adults, and their families. Add the all-too-common struggle to find appropriate mental health services and providers, and despair can spiral out of control.
That struggle is very real, according to Mental Health America (MHA), which regularly analyzes federal data to determine how many people in America need and have access to mental health services. Findings of that analysis are published in MHA’s annual The State of Mental Health in America report.
Last year’s report found that only one mental health care provider is available for every 340 people in the U.S. According to Brian Michel, MHA’s Associate Vice President of Foundations and Government Relations, the provider shortage is even more acute for the country’s youth, over 56% of whom did not receive any mental treatment for their reported major depression.
Brian Michel
“Families in this country face extreme difficulties finding child and teen psychologists and psychiatrists to provide acute care,” he said. “The provider shortage, along with insurance issues, a general lack of mental health literacy, and not knowing what to do or where to go when a young person experiences mental health challenges, means important next steps toward finding treatment often are not taken.”
MHA’s report backs up this concern: 60% of those who say they need to take action to improve their mental health don’t take the next step because they don’t know what they should do.
Early Identification of Mental Health Conditions in Real Time
MHA believes that online screening is one of the quickest and easiest ways to determine whether someone is experiencing symptoms of a mental health condition. It offers a variety of free, confidential online screening tests – including one designed specifically for youth — to provide a quick snapshot of a person’s mental health. After taking the screening, test takers are provided with a list of resources, information, and tools to help them better understand and take steps toward improving their mental health.
“Six million people a year take one or more of our online screening tests to check their mental health concerns, and about 41% of those are youth,” Michel said.
A recent analysis of anonymized data from the screening tests found:
- 49% of all youth depression screeners under 18 reported frequent suicidal ideations on more than half or nearly every day of the previous two weeks.
- 84% of screeners aged 18-24 were at risk for a substance use disorder.
- 88% of youth were at risk for ADHD.
- 88% of people under 18 scored with symptoms of moderate to severe depression.
Integrating Behavioral Health Care at Community Health Centers
MHA’s popular screening programs are a central element in its recently announced partnership with The National Association of Community Health Centers (NACHC). The partnership was created to advance policies and programs promoting integrated behavioral health care in Community Health Centers for children and adolescents.
“Through our National Screening and Prevention Program and our 143 affiliates across the country, MHA is focused on prevention and early intervention,” said MHA President and CEO Schroeder Stribling, in a news announcement. “The power of our partnership with NACHC is already evident at the local level, where our affiliates work side-by-side with local health centers to improve health outcomes in some of the nation’s most underserved communities. Integrating whole-person care is efficient for the providers, convenient for the users, and a dignified way to meet people where they are and address them as whole and unique individuals.”
Both organizations will provide information on screening resources, highlight areas where health centers and MHA affiliates can work together to expand access to integrated care in local communities and states, advocate for regulations and other administrative actions to encourage integrated care, and develop the workforce to meet the demand for care.
“Most people initially access mental health care through their primary care provider, but for those under 18, accessing mental health treatment can take up to a year and providers are often located far away,” Michel said. “Our joint mission is to increase access to care and prevention services by integrating behavioral health care into the primary care setting at the community health centers and federally qualified health centers where so many Americans receive their care. Having these co-located services right in the clinic will make it easier for youth to start and continue prescribed treatments.”
Michel likened the idea of having primary doctors screen all youth for depression and suicide risk at every visit to blood pressure screenings: once blood pressure screenings became a routine part of every doctor’s visit, the prevalence of heart disease began to drop.
“The treatment and recovery process is less arduous and mental health outcomes improve when you address issues early on versus waiting for a crisis or hospitalization,” he said.
The MHA/NACHC partnership will focus on several immediate next steps in 2025:
- Securing funding for the development of research and policy papers to address integrated behavioral health care and school-based clinics.
- Developing an informed perspective on patients’ views of integrated care through focus groups designed to identify gaps and provide a feedback loop between providers and patients.
- Researching current integrated care practices and developing models of how they can be sustained and adapted.
“We are prioritizing school-based best practices because that is where kids spend most of their time and where mental health challenges manifest themselves,” Michel said. “Teachers often have a less polished view of their students than their parents do. They see how they interact socially in class and how they perform academically – all of which reflects their behavioral health.”
Additional and longer-term collaborative efforts will focus on:
- Creating an advisory group of health centers, youth, families, and community organizations, including MHA affiliates
- Creating content and digital assets informed by advisory groups
- Offering tools and technical assistance based on health center and MHA experience
- Creating prevention content on topics such as sleep and social media
- Mobilizing advocates in specific communities and states to support the redefinition of primary care for young people
- Piloting with health centers an integration of behavioral health for youth into clinical settings, including screening and digital health tools
- Researching component to measure key outcomes
- Extensive prevention with new materials and new ways of thinking about prevention
- Systemic policy advocacy to support financing of integration at the federal, state, and local levels
Including Young Adult Voices in Mental Health Programs
Youth programs for those aged 18-25 are an integral part of MHA’s mission and are designed to empower aspiring and established young advocates to ignite their communities and build a mentally healthy future for all.
“We focus on prevention because we know that most mental health conditions begin far earlier than people think,” said Kelly Davis, Vice President for Peer and Youth Advocacy at MHA. “From academic demands and the pressures to be perfect, to the impacts of social media, today’s world is a pressure cooker for young people, especially since the pandemic. We want to encourage everyone to be mindful of how different it is to be young today versus any other period we’ve experienced.”
One of the MHA programs Davis spearheads is the Young Leaders Council (YLC), which is composed of young people aged 18-25 who have created programs and initiatives to fill gaps in mental health support and resources in their communities. Each year, 10 leaders are selected to participate in the six-month leadership development program. Davis herself got involved in mental health advocacy during college and was inspired to create the YLC based on her experiences. MHA’s Young Leaders get involved in policy and public education work, connect others to mental health screenings, work with academic researchers, and even attend events at the White House.
“Young adults have similar experiences, criticisms, and solutions around how to address mental health, but they lacked a common space to come together and build a community at a national level,” she said. “In addition, when you’re young, it can be difficult to get in the right room with the right people at the right time. The YLC was formed to bridge the gap and integrate these young voices and perspectives across everything we do at MHA.”
Each year, the YLC authors an annual youth mental health report documenting youth perspectives, offering recommendations, and inspiring youth-centered solutions to the mental health crisis. Last year’s annual report focused on an intergenerational approach to youth mental health.
“Our YLC members interviewed people who lived through crises like the AIDS epidemic and 9-11 to learn how they made sense of their world during very difficult times,” Davis explained. “Their insights and knowledge of collective trauma and resilience can provide important lessons learned to help inform today’s young people.”
Davis also runs MHA’s Youth Policy Accelerator (YPA) program, which is designed to amplify youth leadership and provide personal and professional advancement to youth leaders to ensure youth priorities and voices are centered in mental health policy on a national level. In 2024, YPA cohorts conducted original research, launched a national youth peer support policy coalition, met with legislators, and created a guide to document the needs of people working in youth peer support.
“Notably, the guide goes beyond identifying good ideas and outlines detailed and actionable recommendations of what needs to happen and when,” Davis said, noting that this approach is quite rare in the youth mental health space.
Davis said that programs like YLC and YPA have not only created pathways for their participants to pursue careers in the mental health field, they also have demonstrated the power of youth voices and leadership.
“When I started at MHA, young people weren’t heavily involved in national spaces and conversations,” she said. “Today it has become an expectation that they will be, and MHA has played a big role in leading that culture change.”
***If you or someone you know needs immediate help, please call 988 or visit https://988lifeline.org for the Suicide and Crisis Lifeline.***
