News Mashup for March 2021
Youth Suicide Patterns in the Child Welfare System
On March 8, the journal Pediatrics published a novel study examining characteristics and health service use patterns of youth in the child welfare system (CWS) who died by suicide. The study, led by Donna Ruch of Nationwide Children’s Hospital, found that suicide decedents were twice as likely to have experienced out-of-home placements relative to a living control population. Suicide decedents were more likely to have diagnosed mental health conditions and substance use disorders relative to the control group, and higher utilization rates of health care services, both mental and physical. These results, the authors contend, point to the need for frequent, ongoing suicide risk assessment of youth involved in the CWS and lend support for family preservation programs. Experts from the National Institute of Mental Health praised the study stating “These results have potential to inform proactive and integrated approaches to suicide prevention in the CWS, a boundaried setting that serves youth at 3.5-fold higher risk for suicide than the general youth population.” Click on the links below to learn more.
Ruch, D. A., Steelesmith, D. L., Warner, L. A., Bridge, J. A., Campo, J. V., & Fontanella, C. A. (2021). Health Services Use by Children in the Welfare System Who Died by Suicide. Pediatrics, 147-3. e2020011585. https://doi.org/10.1542/peds.2020-011585.
Lisa M. Horowitz, Geoffrey Kahn and Holly C. Wilcox. March 8, 2021. The Urgent Need to Recognize and Reduce Risk of Suicide for Children in the Welfare System. Pediatrics, Commentary. Retrieved March 29 from https://pediatrics.aappublications.org/content/early/2021/03/05/peds.2020-043471.
Nationwide Children’s Hospital. March 8, 2021. Investigating Youth Suicides among Children Involved with the Welfare System. EurekAlert, News Release. Retrieved March 25, 2021 from https://www.eurekalert.org/pub_releases/2021-03/nch-iys030521.php.
Lewis First. March 15, 2021, Recognizing and Reducing the Risk of Suicide for Youth in the Welfare System. Pediatrics, Blog. Retrieved March 28 from https://www.aappublications.org/news/2021/03/15/reducing-risk-suicide-welfare-system-pediatrics.
Physician’s Briefing Staff. March 8, 2021. Suicide Decedents in Child Welfare System Had Used Health Services. HealthDay News. Retrieved March 25, 2021 from https://consumer.healthday.com/health-conditions-up-for-suicide-decedents-in-child-welfare-system-2650888068.html.
Emotional and Behavioral Health as Part of Standard Care during COVID-19 Pandemic
On March 10, the American Academy of Pediatrics (AAP) issued an update to its guidance on supporting children and youth during the COVID-19 pandemic. The guidance articulates the need for pediatricians to address emotional and behavioral health as part of standard care, partnering with agencies and other professionals for screening, referrals, and follow up. AAP emphasizes that young people with special health care needs, and those involved with the child welfare and juvenile justice systems, may be especially vulnerable to the loneliness, isolation, and uncertainty associated with the pandemic, a crisis straining an “already challenged behavioral health infrastructure.” Noting that the full impact of the crisis “may not manifest until well after the event and can persist for years” the AAP challenges pediatricians to join “child welfare professionals in devising optimal ways to serve children and families during the pandemic and beyond.”
An opinion published by the Kennedy Forum on March 2 likewise asserts that integration of behavioral health and physical health is key to the nation’s pandemic recovery, arguing that “for far too long, those with behavioral health challenges have been relegated to a separate and unequal system of care.” Practice and policy adopted now, in the midst of the COVID-19 pandemic, “can set a powerful new precent to guide public health for years to come.” Click on the links below to learn more.
American Academy of Pediatrics. March 10, 2021. Interim Guidance on Supporting the Emotional and Behavioral Health Needs of Children, Adolescents, and Families During the COVID-19 Pandemic. Retrieved on March 28, 2021 from https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/interim-guidance-on-supporting-the-emotional-and-behavioral-health-needs-of-children-adolescents-and-families-during-the-covid-19-pandemic/.
American Academy of Pediatrics. January 25, 2021. Guidance for Children and Families Involved with the Child Welfare System During the COVID-19 Pandemic. Retrieved March 28, 2021 from https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/guidance-for-children-and-families-involved-with-the-child-welfare-system-during-the-covid-19-pandemic/.
The Kennedy Forum. March 2, 2021. Integrating Behavioral Health and Physical Health is Key to National Recovery. Retrieved March 25 2021 from https://www.thekennedyforum.org/blog/integrating-behavioral-health-and-physical-health-is-key-to-national-recovery/.
Trisha Korioth. March 15, 2021. Updated Guidance Focuses on Mental Health Risks, Needs during Pandemic. AAP News. Retrieved March 28, 2021 from https://www.aappublications.org/news/2021/03/15/ebhguidance3-15-21.
Hill, R. M., Rufino, K., Kurian, S., Saxena, J., Saxena, K., & Williams, L. (2021). Suicide Ideation and Attempts in a Pediatric Emergency Department Before and During COVID-19. Pediatrics, 147(3), e2020029280. https://doi.org/10.1542/peds.2020-029280.
Annual Report on Children's Well-Being
On March 31, The Children’s Defense Fund (CDF) published their annual report The State of America’s Children® 2021. The report presents data on child population, child poverty, income and wealth inequality, housing and homelessness, child hunger and nutrition, child health, early childhood, education, child welfare, youth justice, gun violence and immigration. Most of the data included in the report reflect realities prior to the pandemic; “even the most recent available data sets do not fully encompass how this past year has shaped our lives” says CDF, noting that an additional 2.5 million children have fallen into poverty since the start of the pandemic and levels of depression and despair, especially among Black children and youth, are surging. Click on the link below to learn more.
The Children’s Defense Fund. March 31, 2021. The State of America’s Children® 2021. Retrieved April 1, 2021 from https://www.childrensdefense.org/state-of-americas-children/?utm_source=cultivation&utm_medium=email&utm_campaign=soac2021.
Many High-Risk Youth Not Receiving Behavioral Health Services
A study published on March 15 in JAMA Network Open indicates that 40% to 60% of young people with adverse childhood experiences and/or high-level mental health symptoms do not receive clinical behavioral health care. Combining findings from three cross-sectional surveys comprising 11, 896 individuals, the researchers found that Black and Hispanic children had significantly lower levels of clinical contact compared with non-Hispanic White children and, notably, children in non-traditional family structures were more likely to have clinical contact than their counterparts living with 2 biological parents. Speaking with Healthday Reporter Sarah Collins, the lead author, David Finkelhor (University of New Hampshire) argues that we need to get better at reaching at-risk populations. Finkelhor advocates for increasing the number of behavioral health specialists providing effective, evidence-based care; locating client services in more convenient, community-centric locations; and working to reduce mental health stigma. Click on the links below to learn more.
Finkelhor, D., Turner, H., & LaSelva, D. (2021). Receipt of Behavioral Health Services Among US Children and Youth With Adverse Childhood Experiences or Mental Health Symptoms. JAMA Network Open, 4(3), e211435. https://doi.org/10.1001/jamanetworkopen.2021.1435.
Sarah Collins. March 29, 2021. Why Are Half of U.S. Kids With Mental Health Issues Not Getting Treatment? HealthDay. Retrieved April 1, 2021 from https://consumer.healthday.com/3-29-why-are-half-of-u-s-kids-with-mental-health-issues-getting-no-treatment-2651145595.html.
University of New Hampshire. March 18, 2021. UNH Research: Over Half of At-Risk Youth Not Receiving Needed Mental Health Services. University of New Hampshire Newswise. Retrieved March 28, 2021 from https://www.newswise.com/articles/unh-research-over-half-of-at-risk-youth-not-receiving-needed-mental-health-services?ta=home.
Megan Glossan. March 30, 2021. Kids Aren't Receiving Care For Mental Health Issues, Finds Study. Moms.com. Retrieved April 1, 2021 from https://www.moms.com/kids-lack-mental-health-services/
COVID’s toll on Youth Mental Health
On March 2, FAIR Health released what is perhaps the most expansive study of the effects of the pandemic on pediatric mental health. Examining over 32 billion private healthcare claims, FAIR Health found that mental health claims in March and April 2020 were twice that of March and April 2019 for individuals age 13 to 18. The same month/year/age comparisons showed intentional self-harm claims rose by more than 90% while overdoses and substance use disorder claims were higher by over 94%. Claims for generalized anxiety disorder were 94% higher in April 2020 compared to April 2019; claims for major depressive disorder and adjustment disorder increased by more than 80%. Click on the links below to learn more.
Fair Health. March 2, 2021. A Study of Private Healthcare Claims. FAIR Health White Paper. Retrieved April 3, 2021 from https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/The%20Impact%20of%20COVID-19%20on%20Pediatric%20Mental%20Health%20-%20A%20Study%20of%20Private%20Healthcare%20Claims%20-%20A%20FAIR%20Health%20White%20Paper.pdf
Tommy Beer. March 3, 2021. Self-Harm Claims Among U.S. Teenagers Increased 99% During Pandemic, Study Finds. Forbes. Retrieved March 31, 2021 from https://www.forbes.com/sites/tommybeer/2021/03/03/self-harm-claims-among-us-teenagers-increased-99-during-pandemic-study-finds/?sh=dc4e59333e05.
More Stories in March: US Lawmakers Want More Research on Coronavirus Pandemic's Mental Health Toll CNN – 3.9.21; Eating Disorders Among Teens Surging During the Pandemic EdSource – 3.11.21; Mental Health Crisis Affecting Young People Needs Immediate Attention, Report Says NYT 3.21.21; How the Pandemic has Impacted Teen Mental Health Mott Report – 3.15.21; The Lost Year: What the Pandemic Cost Teenagers ProPublica – 3.8.21; Data: What We Know About Student Mental Health and the Pandemic. Education Week – 3.31.21; Children’s Mental Health During COVID-19, Now a Growing Concern Among Psychology Experts. Science Times – 3.3.21; Are the Kids Alright? Palo Alto Weekly – 3.12.21 Mental State of the World 2020 Sapien Labs - 3.15.21; Bay Area lawmaker’s bill would make 988 the 911 of mental health emergencies East Bay Times - 3.28.21; Professionals, Not Police, Should Respond to Mental Health Crises CalMatters - 3.31.21; Rise in Youth Suicide Needs Joint Effort from Educators, Health Providers CalMatters - 3.24.21
