Senators pressed on mental health awareness in schools

Improving mental health care means educating young people, investing in the workforce and science and breaking down barriers to treatment, witnesses told senators during a hearing of the Senate Committee on Health, education, work and pensions (HELP) on Tuesday.

Suicide concerns previously centered on adults 25 to 45, but more recently that ‘suffering’ has spilled over to 10, 11 and 12-year-olds, Sen. Lisa Murkowski (R-Alaska) said in her remarks. opening remarks, she spoke while briefly replacing Richard Burr (RN.C.), a ranking member of the committee.

“We have an obligation to hear and respond” to these issues, she said, noting that Alaska has the second-highest suicide rate of any state in the country.

Claire Rhyneer, a recent high school graduate from Anchorage, Alaska, and mental health advocate, shared the story of her own “dark times” during the hearing.

Claire Rhyneer, mental health advocate in Alaska

Because she had no knowledge of mental health issues when she was depressed and hurting herself, she took online surveys to find out if she needed help. Searching the internet, she discovered “disturbing” videos and images, and found herself continually coming back to them.

Looking back, Rhyneer said his own behavior worries him. Equally disturbing, even as she hurt herself physically, she still wasn’t sure she was sick and needed help. It was only after finding a group of peers who shared her problems that she was able to heal and recover.

One in five high school students in Alaska have seriously considered suicide and one in four have attempted suicide, Rhyneer noted, citing results from the 2019 Alaska Youth Risk Behavior Survey.

“It’s a fifth of my classmates,” she said. “How many parents do you think knew about this?”

Young people are afraid to speak. Sometimes they think they don’t need help, or they play down their problems, she added. “They’re afraid of being seen as weak, or crazy, or attention-seeking… wacky, broken, a lost cause, any of those things.”

Rhyneer, who took a ‘gap year’ to work for the National Alliance on Mental Illness, is working with other mental health advocates to try to pass a bill to bring health education mental health in K-12 schools.

Health classes already cover topics like nutrition, dental health and cancer prevention, she said, “and mental health deserves to be a topic in one of those classes. is just as important.”

“We have the tools to build resilience in children,” said Mitch Prinstein, PhD, scientific director of the American Psychological Association. “We just need to be able to teach all those teachers, counselors and administrators what we know, so that we can help them identify children before they reach a moment of trauma.”

In addition to schools, hospitals are battling an increase in mental health cases and emergency departments are overcrowded due to a shortage of psychiatric beds. Prinstein noted that children’s hospitals saw a 42% increase in injury and suicide cases in 2021.

Sen. Maggie Hassan (DN.H.) said she received letters from young voters who had spent up to a month waiting in emergency departments for a hospital bed. Some were kept in solitary confinement for weeks without a shower. The situation was so dire that the state eventually dipped into federal funds and purchased a local hospital so it could remove some of these children from emergency departments.

Asked what Congress can do to reduce the backlog in psychiatric care, Prinstein said that while adding more hospital beds might seem like the answer, the real solution is further upstream: increasing the number of outpatient care. The science is there and the treatments work; what is needed are more people to deliver the treatments and prevent children from reaching a crisis stage, he urged.

The United States invests $15 billion a year to ensure the country has enough clinicians to provide physical health care in the appropriate specialties, but only 1% of that funding goes to the workforce. work in mental health, noted Prinstein.

As for immediate action Congress could take, more than 5,000 psychology interns could help bolster the mental health workforce if Medicare reimburses them during residency, the same way medical residents are reimbursed, a- he declared.

He called for expanding higher education programs in psychology and scholarships for minorities, and increasing loan repayments for mental health professionals.

Prinstein also urged Congress to increase funding for the National Institute of Mental Health, the National Institute of Child Health and Human Development, and the National Institute on Child Health by $1 billion. minorities and health disparities, arguing that this amount represents a “very small proportion of the allocation” for other conditions that affect far fewer young people than mental health disorders.

Another witness, Michelle Durham, MD, MPH, a pediatric and adult psychiatrist at Boston Medical Center, described barriers to providing evidence-based mental health care, noting the prior authorization requirements that providers face. when transferring a patient to an inpatient psychiatric facility. .

“You would never do that with someone who comes to the emergency room with a heart attack,” but social workers, case managers and sometimes doctors often spend hours trying to get permission for a bed, a she declared.

Similarly, Durham fought to keep children on medication after insurers changed their formularies. It can take hours, leaving her less time for patient care, she noted. “We need to have parity for physical and mental health, and not have to be available to all … of these ‘prior authorizations’.”

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    Shannon Firth has reported on health policy as MedPage Today’s Washington correspondent since 2014. She is also a member of the site’s Enterprise & Investigative Reporting team. To follow

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