Strategies to Expand Access to Care and Improve Preparedness

Please respond to discussion below

Identify at least two resources that are needed to address the mental health needs of the pediatric population.

As described in the above study, rates of anxiety and depression in adolescents have doubled from depression affecting 12.9% to 25.2% and anxiety increased from 11.6% to 20.5% (Racine et al., 2021). As providers, we must identify resources to address this disheartening information. One resource that is needed is more mental health workers employed within school settings which includes guidance counselors, LCSWs, LCPC and PMHNPs. Schools provide low barrier access as children can be transported to and from and is often viewed as a safe, welcoming space for children. When mental health services are available in schools, multiple barriers to care are eliminated. Firstly, providers have openings, are taking new patients and in some cases, services are not billed, (providers are paid from school budget) and services are at no cost to families. Second, parents do not need to take off work, find childcare for other children, pay for gas or use public transportation to get their child seen. Third, children generally feel safe and accepted in the school and may be comfortable with the provider since they see them around school and at school functions. Lastly, research shows that when referred to an outside mental health provider, most children do not attend their first visit and of those who do, 35-75% end treatment earlier than recommended (Stempel et al., 2019). Another resource that is needed to address mental health needs in the pediatric population is more awareness and understanding. Teachers and support staff should be trained to address trauma. Children enrolled in school full time, will often spend more time within school with teacher and support staff than with their family. Therefore, it is important they are able to recognize behaviors and responses that may indicate a child needs further intervention. There are many programs such as sources of strength that provide curriculum and training for school staff.

Describe one strategy at the local, state, national, or international levels to expand access to care. 

One strategy that has been already implemented is the American Rescue Plan act. This was passed in March 2022 and provided 170 billion dollars in school funding which could be used to hire mental health workers including school psychologists, LCSWs/LCPCs and PMHNPs (Abramson, 2022). But what will happen when this funding runs out? Will schools be able to continue to afford having mental health staff on payroll? It is important additional funding is secured to continue to pay for this. A strategy would be to lobby at the local and federal level and continue to stress the importance of continued funding.

Discuss the potential repercussions that may occur if these mental health needs are not addressed.

If these needs are not met, we can expect to see catastrophic consequences for generations to come. Adolescents with untreated anxiety and depression may turn to drug and alcohol use in an attempt to self-medicate, self-harm including non-suicidal self-injurious behavior will increase which will lead to more urgent care/ER visits for laceration repair or burn care, this would create a financial burden on the healthcare system, suicide attempts and completed suicides will continue to rise, inflicting further trauma on their surviving families, siblings and friends, ultimately leading to more mental health needs. These are only a few of the repercussions that will follow should we not take this mental health crisis seriously.

Describe one strategy to improve preparedness to address mental health concerns in future public health emergencies. Identify who should be involved.

The American Psychiatric Association has put together a guidance document highlighting preparedness in the event of a future public health emergency. Its framework emphasizes four topics, enhancing patient experience, improving public health, reducing costs, and improving provider wellbeing (APA, 2020). I chose to focus on improving provider wellbeing and although there are many steps that may be taken to do this, I want to focus on training. Focus on future crisis preparedness is necessary and unfortunately as COVID 19 wreaked havoc across the world, many providers and hospital systems were left flying by the seat of their pants. Things like having an adequate stockpile of masks and gloves, staff being fitted for N95 masks and training in crisis situations were lacking. Inevitably there is going to be another public crisis. Who is going to care for the providers who at the front lines? How are psychiatric providers going to support their peers if they are not adequately trained in crisis preparedness (APA, 2020)? Working with office administrators, local EMTs, emergency room staff and local providers will be necessary to ensure all providers, whether cardiac to GI or psychiatric, are properly trained for the next public health emergency.

Abramson, A. (2022). Children’s mental health in crisis. Retrieved on 1/25/2023. https://www(dot)apa(dot)org/monitor/2022/01/special-childrens-mental-healthLinks to an external site.

American Psychiatric Association (APA) (2020). COVID-19 Pandemic Guidance Document. CHANGING THE SYSTEM: CULTIVATING PREPAREDNESS FOR FUTURE PUBLIC HEALTH EMERGENCIES. Retrieved on 1/25/2023. https://www(dot)psychiatry(dot)org/File%20Library/Psychiatrists/APA-Guidance-Preparedness-for-Future-Public-Health-Emergencies.pdf

Stempel, Cox‐Martin, M. G., O’Leary, S., Stein, R., & Allison, M. A. (2019). Students Seeking Mental Health Services at School‐Based Health Centers: Characteristics and Utilization Patterns. The Journal of School Health, 89

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