By Lance Chilton
In 2013, then-Governor Susana Martinez’s administration cut off Medicaid funding to 15 agencies providing behavioral health services in New Mexico, alleging overbilling. In 2016, Attorney General Hector Balderas exonerated those agencies. In 2020, a pandemic-fueled behavioral health crisis began among our state’s children and adolescents. In 2023, families, pediatricians, and others who care for children are finding it increasingly difficult to find behavioral health providers for troubled kids.
New Mexico’s child health care professionals, including pediatricians and school nurses, have expressed concerns about children they see in their schools and practices—in particular, the children’s emotional well-being. It’s not just New Mexico: many essayists, including those writing for the New York Times, the American Academy of Pediatrics (AAP), and psychologists at Johns Hopkins University, have commented on concerns over young people’s emotional health.
Hopkins clinical psychologist Tamar Mendelsohn notes that “As teens, they’re developing into who they’re going to be as adults; if they’re dealing with a mental health issue, it can derail the process. Part of the crisis is that there are so many young people suffering needlessly because we have a lot of helpful resources and supports they aren’t getting. [Maybe that’s so in Baltimore. Here in New Mexico children may not be getting services because they’re so hard to find.] I’m a big fan of prevention and promotion. Instead of only talking about treatment, let’s invest in creating safe and supportive schools and communities for our young people.”
In 2021, a statement from the AAP and the American Academy of Child and Adolescent Psychiatrists includes the following: “The pandemic has struck at the safety and stability of families. More than 140,000 children in the United States lost a primary and/or secondary caregiver, with youth of color disproportionately impacted. We are caring for young people with soaring rates of depression, anxiety, trauma, loneliness, and suicidality that will have lasting impacts on them, their families, and their communities. We must identify strategies to meet these challenges through innovation and action, using state, local and national approaches to improve the access to and quality of care across the continuum of mental health promotion, prevention, and treatment.”
A March 2022 New York Times article updated the number of children who had lost a parent to COVID to “more than 200,000.” But has only COVID been responsible for the increasing rates of mental distress among children and teens? The Times concludes “No” and quotes a Children’s Hospital of Chicago psychiatrist: “Pre-Covid we had a mental-health crisis. The biggest misconception is that COVID makes people mentally ill. From my point of view, COVID unmasked people who have underlying vulnerabilities.”
Regardless of whether COVID and the restrictions it brought caused or unmasked emotional disorders, it’s clear that they are there and that youth need help. It’s also clear that help is hard to get in New Mexico. The new 988 Crisis Now line will help – its recent statistics show that almost 30% of its calls deal with suicidal ideation and another 12% with depression.
During the last 6 months, the Legislative Health and Human Services Interim Committee has several times heard testimony on how these problems play out here, and what can be done about them.
Here is a list of some of the proposed solutions:
- A bill to set up a fund to support the start-up of new or expanded provider agencies to cover expenses before reimbursements replenish operating cash.
- A bill to clarify Medicaid reimbursement for crisis triage centers and to encourage law enforcement personnel to take people to these centers rather than to jails or hospitals.
- A memorial to study the cost and feasibility of providing free tuition for graduate degrees for persons who would become behavioral health providers in New Mexico.
- A memorial to study the feasibility of creating/expanding certification programs in community colleges for peer counseling and other non-clinical support services.
- Additional funding for school-based health centers providing behavioral health services.
- A bill to expand coverage of behavioral health services under Medicaid and commercial insurance, based on a much broader interpretation of mental health parity.
Let’s hope that some of these get passed and fit into our fortunately expanded budget. If children are our future, then attending to their mental health is vital to our future.