Children and teens in our country are experiencing a mental health crisis. Even before the pandemic, this crisis was severe, with 1-in-5 children under the age of 18 experiencing a mental health issue, and the suicide rate among youth aged 10-to-24 increasing nearly 60% between 2007 and 2018. In the first 6 months of 2021, these numbers skyrocketed: children’s hospitals reported a 45% increase in self-injury and suicide in children ages 5-to-17 compared to the first 6 months of 2019. While the mental health challenges of the pandemic have affected children of all backgrounds, they have disproportionately impacted children of color.

The increased demand for mental health services coincides with a severe lack of resources for children and teens. Children experience mental health issues at the same rate as adults (1-in-5 adults has a mental health issue), yet they have significantly less support. Among the many reasons for this situation are: 

  1. Lack of parity: The lack of parity for mental health services in the U.S. healthcare system has led to woefully inadequate services for children, teens, and adolescents both in Medicaid and through private health insurance. Many parents, regardless of whether they are covered through Medicaid or private insurance, cannot find providers for their children because provider networks are limited, higher co-pays are required for mental health services than for traditional health services, limits are placed on the number of visits a child can have, and prior authorizations can delay a child or teen being admitted for in-patient care during a crisis.
  2. Workforce shortage: The U.S. is experiencing a serious shortage of mental health professionals. The U.S. spends $15 billion annually on the development of the healthcare workforce, but less than 1% of that goes toward mental health professionals. Of that 1%, even less is spent to train and develop specialists in pediatric and teenage behavioral health issues. Consider this: The U.S. currently has 10 child psychiatrists per 100,000 children; experts estimate that we need 47 per 100,000 to address the current crisis. 

In addition, the COVID-19 pandemic has significantly increased the demand for services among young people. More than 200,000 children and youth in this country — the majority of them belonging to racial or ethnic minorities — have lost a primary caregiver to COVID-19, exacerbating both the mental health crisis and its inequitable impact.

What Can Be Done?

Doctors, advocates, and health care policymakers offer the following recommendations: 

  • Ensure there is parity for behavioral health care in both public and private insurance.
  • Expand the mental health workforce and training for professionals who care for children—school counselors, social workers, child care providers, psychologists, psychiatrists, and others — to begin meeting children’s needs at birth.
  • Invest in school-based mental health models to meet children where they are.
  • Invest in peer-to-peer support networks, which have proven effective in addressing the needs of children and teenagers.
  • Invest in community-based mental health services.
  • Ensure that crisis response systems, including the development of state 988 mental health hotlines, include strategies that specifically address the needs of children and youth. 
  • Monitor and meet the needs of children who have lost a caregiver to COVID-19.

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