Running head: ISSUES IN CHILD MENTAL HEALTH POLICY
1
Analysis of the Issues in Child Mental Health Policy of the United States
Problem Statement
Two-thirds of the twenty percent of young people in the United States that suffer from
mental disorders lack access to treatment that would improve their ability to get an education,
complete it, and enjoy the various opportunities available in the country. The current situation of
the management of the mental health problems of children and adolescents in the country
requires a comprehensive policy to prevent its impact on the rise of juvenile crime rates, labor
shortages, and other social problems.
ISSUES IN CHILD MENTAL HEALTH POLICY
2
Annotated Bibliography
Alegría, M., Green, J. G., McLaughlin, K. A., & Loder, S. (2015). Disparities in child and
adolescent mental health and mental health services in the US. A William T. Grant
Foundation Inequality Paper.
In this article, the authors studied the increasing rate of inequality in mental health services in the
context of the causes of the problem and effectiveness of current interventions to end
specific disparities. Alegría, Green, McLaughlin, and Loder (2015) stated that despite the
progress made in some areas of the health services industry in the country, young people
with mental health problems from minority group still lack access to these services. They
recommended that researchers and policymakers should endeavor to design and develop
interventions that would contribute to improving the conditions of children and
adolescents with mental problems. An evaluation of the integrity and value of this article
showed that the authors’ extensive review of the literature and dependence on data and
figures on topic enhanced its quality. It is this reason and several others including the
quality of the content that would make it a valuable source of reference for the proposed
paper.
Bui, A. L., Dieleman, J. L., Hamavid, H., Birger, M., Chapin, A., Duber, H. C., ... &
Murray, C. J. (2017). Spending on children’s personal health care in the United
States, 1996-2013. JAMA Pediatrics, 171(2), 181-189.
Health care spending in the United States has been a contentious issue because of the lack of
information on the distribution of the cost to the various population groups. In this article,
Bui and colleagues reported the findings of a review of aggregate health care spending
from 1996 to 2013 in the country, which showed that spending on mental disorders for
ISSUES IN CHILD MENTAL HEALTH POLICY
3
children was the second largest. The implication of this study is that despite this huge
spending on ADHD for children, policymakers still have a long way to go regarding
access to treatment and reduction of the impact of the condition on patients. This source
is an important one for understanding the economic and financial dimension of the
problems with the health policies in the country. Also, the validity and credibility of the
data would enhance the quality of the recommendations proposed in the paper
Cuellar, A. (2015). Preventing and treating child mental health problems. The Future of
Children, 25(1), 111-134.
Allison Cuellar wrote that the “policies and programs of the United States regarding the children
with mental illnesses are fragmented and uncoordinated thereby making the benefits
derivable from them unavailable. She argued that mechanisms of the treatment systems
are not designed to be preventative or have long-term effects on the issues associated
with the condition. Therefore, the rate of child mental health problems is increasing
without effective strategies to reduce their impact on the quality of life of these patients.
The reason for the selection of article as a reference for this paper is based on the various
points and data used by Cuellar (2015) to support the information provided. Also, it is
credible source since it relied on relevant and current literature to support the arguments
presented in the article.
Cummings, J. R., Wen, H., & Druss, B. G. (2013). Improving access to mental health
services for youth in the United States. Jama, 309(6), 553-554.
The need to critically examine the mental health treatment system in ways that would lead to
policies that ensure increased access to them by communities with the right infrastructure
is the focus of this article by Cummings, Wen, and Druss (2013). The authors argued that
ISSUES IN CHILD MENTAL HEALTH POLICY
4
current gaps as evident from data from the 2008 mental survey are an indication that the
nation needs to more regarding the infrastructure for community services as stipulated by
the law. They concluded that a review of the implementation protocol is required to solve
the problems of shortages of MH providers, stigmatization, and treatment centers for this
demographics of health consumers. In my opinion, this article is a valuable source of
information for understanding the factors responsible for the failure of the policies to
achieve the desired impacts. It would enhance the quality of the proposed study in several
ways.
Fajardo-Bullón, F., Rasskin-Gutman, I., Felipe-Castaño, E., Ribeiro dos Santos, E. J., &
León-del Barco, B. (2017). Analysis of Predictive Factors on Minors’ Mental Health
According to the Spanish National Health Survey. Brain sciences, 7(10), 135.
The authors of this article focused on the high incidence rate of children’s mental health
problems through an analysis of the factors that result in these conditions. FajardoBullion et al. (2015) conducted this research on Spanish children through the examination
of the social determinants of the conditions and their role in its exacerbation. The
researchers concluded that the design of health policies and programs should integrate the
care systems used for children from poor occupational and health backgrounds. Also, the
instruments used for the conduct of the project were standardized and universal thereby
making the findings as credible as possible. It is this reason and several others that
influenced the decision for the inclusion of this article as one of the references for the
research paper/
Garland, A. F., Haine-Schlagel, R., Brookman-Frazee, L., Baker-Ericzen, M., Trask, E., &
Fawley-King, K. (2013). Improving community-based mental health care for
ISSUES IN CHILD MENTAL HEALTH POLICY
5
children: Translating knowledge into action. Administration and Policy in Mental
Health and Mental Health Services Research, 40(1), 6-22.
In this article, Garland et al. (2013) conducted a selective review with the objective to highlight
and synthesize existing knowledge on the measures required by the public health system
of the United States to ensure that its strategies are achieving the desired results. The
result of the study is a multi-level framework that can lead to improvement of treatment
targets and evidence-based practices. They concluded that community-based mental
health care for children and their families is an imperative that should be considered by
policymakers and stakeholders in the development of policies and programs. This
reference is credible one for the formulation of recommendations for the determination of
measures that can lead to resolution of the issues that surround children mental health.
Harper G. (2012). Child and adolescent mental health policy. In Rey JM (ed), IACAPAP eTextbook of Child and Adolescent Mental Health. Geneva: International Association
for Child and Adolescent Psychiatry and Allied Professions.
Harper (2012) wrote that the “public policy for children mental health should address the
disparities that could prevent the children from attaining their full potential in life
circumstances, endowment, and services. He argued that the most appropriate measures
for understanding the sources of the problem include the consequences of the disparate
endowment, life circumstances, and effectiveness of the interventions. Although these
approaches are included in most of the policies and programs used for managing the
issues of child and adolescent mental health, the results of the treatment systems have
yielded minimal benefits. While the credibility and integrity of the information contained
ISSUES IN CHILD MENTAL HEALTH POLICY
6
in this article can be ascertained, its primary purpose for the research paper is to
contribute to the evidence used to support the viewpoints of the author.
Kutcher, S., & McDougall, A. (2009). Problems with access to adolescent mental health
care can lead to dealings with the criminal justice system. Paediatrics & child
health, 14(1), 15-18.
Kutcher, S., & McDougall, A. (2009) examined the issue of mental disorders in young people
from the dimension of its role in the increasing rate of juvenile crimes in this article. The
scholar noted that the failure of the public health system to provide the required services
for dealing with this problem in the youth population is responsible for the over 70% of
young offenders that have mental disorders. They concluded that a combination of social,
legal, and medical interventions is urgently needed to address the problem. An analysis of
the quality and relevance of the information in this article to the credibility and integrity
of the research paper showed that the authors’ extensive review of the literature on the
connection between mental illness and potential for crime is the reason for its inclusion in
the list of references. Also, the capacity of the content to provide insights to both the
short- and long-term impact of mental illness in children is an added value.
McMorrow, S. (2010). State mental health systems for children: A review of the literature
and available data sources.
This analytical review of the literature and data sources on the performance of state governments
in the management of healthcare policies and programs for children’ s mental health
showed huge gaps in the various elements of the initiatives. McMorrow (2010) noted that
“children are clearly not immune to the challenges of mental illness and they share many
of the difficulties of their adult counterparts in accessing effective services.” Therefore,
ISSUES IN CHILD MENTAL HEALTH POLICY
7
he concluded that despite belonging to the vulnerable population, these children need
better healthcare, educational, and social outcomes to succeed as adults. A measure of the
integrity and value of this article showed that the authors’ extensive review of the
literature and dependence on data and figures on topic enhanced its quality. It is this
reason and several others including the quality of the content that would make it a
valuable source of reference for the proposed paper.
Primer, A. (2011). Mental health financing in the United States. Kaiser Commission on
Medicaid and the Uninsured
In this report, Primer (2011) stated that the complexity of the system used for the management of
the various funding sources for mental health and substance abuse services in the United
States is the leading cause of the challenges experienced by policymakers in formulating
efficient policies. The authors conducted a detailed examination of the issues through an
analysis of the mechanisms used for funding the system. Furthermore, the report
concluded that the best approach for resolving the policy problems in financing mental
health care services all levels in the country is through a complete modification of the
complex systems that cater for the resources used for the most vulnerable individuals.
While the credibility and integrity of the information contained in this article can be
ascertained, its primary purpose for the research paper is to contribute to the evidence
used to support the viewpoints of the author.
ISSUES IN CHILD MENTAL HEALTH POLICY
8
References
Alegría, M., Green, J. G., McLaughlin, K. A., & Loder, S. (2015). Disparities in child and
adolescent mental health and mental health services in the US. A William T. Grant
Foundation Inequality Paper.
Bui, A. L., Dieleman, J. L., Hamavid, H., Birger, M., Chapin, A., Duber, H. C., ... & Murray, C.
J. (2017). Spending on children’s personal health care in the United States, 19962013. JAMA pediatrics, 171(2), 181-189.
Cuellar, A. (2015). Preventing and treating child mental health problems. The Future of
Children, 25(1), 111-134.
Cummings, J. R., Wen, H., & Druss, B. G. (2013). Improving access to mental health services
for youth in the United States. Jama, 309(6), 553-554.
Fajardo-Bullón, F., Rasskin-Gutman, I., Felipe-Castaño, E., Ribeiro dos Santos, E. J., & Leóndel Barco, B. (2017). Analysis of Predictive Factors on Minors’ Mental Health According
to the Spanish National Health Survey. Brain sciences, 7(10), 135.
Garland, A. F., Haine-Schlagel, R., Brookman-Frazee, L., Baker-Ericzen, M., Trask, E., &
Fawley-King, K. (2013). Improving community-based mental health care for children:
Translating knowledge into action. Administration and Policy in Mental Health and
Mental Health Services Research, 40(1), 6-22.
Harper G. (2012). Child and adolescent mental health policy. In Rey JM (ed), IACAPAP eTextbook of Child and Adolescent Mental Health. Geneva: International Association for
Child and Adolescent Psychiatry and Allied Professions.
ISSUES IN CHILD MENTAL HEALTH POLICY
9
Kutcher, S., & McDougall, A. (2009). Problems with access to adolescent mental health care can
lead to dealings with the criminal justice system. Paediatrics & child health, 14(1), 1518.
McMorrow, S. (2010). State mental health systems for children: A review of the literature and
available data sources.
Primer, A. (2011). Mental health financing in the United States. Kaiser Commission on Medicaid
and the Uninsured.
ISSUES IN CHILD MENTAL HEALTH POLICY
10
BACKGROUND AND LANDSCAPE
Youth mental health is a crucial part of the health of the United States general population.
As important as health gets, especially for the young people, there is a conspicuous lack of policy
to allow access to health services at affordable rates in the country. According to Harper (2012),
17-20% of the youth in the country develop mental health issues at some point in their lives.
Furthermore, 70% of mental disorders develop before the age of 25. This makes the youth and
children the most vulnerable groups when it comes to mental health issues in the country.
Therefore, it is evident that the lack of elaborate policies governing their treatment and access to
care jeopardizes the future of the youth in the country. The high levels of mental health issues
developing among the youth make it necessary to look into policies that will ensure that the
youth is considered in the development of preventive and treatment initiatives addressing mental
health.
The effects of mental illnesses on any particular subset of a population are devastating. If
left untreated, mental disorders can affect all aspects of health including emotional well-being
and social development. The adverse effects on the developmental needs of children bar the
children from reaching their social goals and thus curtails their abilities to interact socially with
others. The results of such developmental retardation include stigmatization, social isolation, and
could even be depressive to the youth. On the contrary, addressing the issues of mental illnesses
early in life, a significant reduction of emotional and behavioral problems, functional
impairment, and contact with law enforcement are realized (Harper, 2012). There is a huge gap
between individual organizational efforts and the policy implementation on a national level.
Therefore, policy development to address youth mental issues is necessary to allow the affected
population to access the required care.
ISSUES IN CHILD MENTAL HEALTH POLICY
11
The percentage of the youth seeking out-patient mental health services in the U.S has
been on the constant increase. Between 1996 and 1998, 9.2% of youth in the country sought
outpatient mental health services. This number increased to 13.3% between 2010 and 2012. The
increase in number of youths with less severe or no impairment at all was the highest, but those
with the severe ailments formed the bulk of those seeking outpatient care. From this information,
it is evident that the number of youth who are seeking mental health care is constantly
increasing. That goes to show that there is an emerging need to put policies and initiatives in
place to solve the issue at hand. Further, according to Primer (2011), there is a complicated
system for the management of mental health funding in the U.S. This system has limited the
ability of policy-makers to come up with effective policies that could be utilized.
The number of children experiencing mental disorders in the country is very high.
Similarly, over 70% of young offenders who are incarcerated have mental health problems. In
2010, approximately 70800 young offenders were in incarceration. Doing the math, it is evident
that mental health disparities may be blamed for the increased number of young offenders.
Garland et al. (2013) discovered that there is a huge lack of child-dedicated mental health
facilities and policies in the country. Essentially, this leaves the youth vulnerable. To show the
gap that exists in youth mental health care, suicide is the third leading cause of death among the
youth, and 90% of those who die by suicide have underlying mental issues. This goes to show
that there is an acute need for attention to the issue.
Several factors have to be considered when it comes to developing policies addressing
the youth and mental health. The leading factor is the financial approach to the development of
elaborate policies addressing children and youth mental issues. The Congressional committees
on finances are the main players in the factor of financial approach. The mental health policies
ISSUES IN CHILD MENTAL HEALTH POLICY
12
have to be handled from the national government perspective which forms the foundation for
deploying initiatives funded by the Federal Government. The number one determinant of the
efficiency of any policies that could be formulated and initiatives is the funding of those
initiatives. More investment in preventive care is required to ensure that the less severe cases are
diagnosed early in life and managed to allow the leading of a normal life and reduction in
disruptive behavior. The financial factor also has to consider the affordability of the care to
different subsets in the society.
The other category of factors to consider when developing such policies is the social
factors that affect the possible formulation and implementation of the policies. The first social
issue that is significantly affecting the health of the youth in the country is the racial minority
access to care. According to Lau et al. (2012), health disparities across racial identities are
amplified among the youth with the majority of Latino youth lacking personal doctors and
African-American youth lacking access to particular medication in the past. This evidence serves
as just the tip of the iceberg when the overall disparities in access to healthcare are reviewed.
Therefore, this guides to the need for the presentation of initiatives to ensure the equality of
access to mental health policies. This approach would allow racial minorities to access care at the
same level with majorities and close the gap between the quality of care provided to the two
sides.
Another social factor to consider when developing mental health policies for children and
the youth is the family relationships and the care provided to children. Garland et al. (2013)
advance that one issue that mostly contributes to or worsens mental disorders in children is
family instability. This refers to the lack of parental guidance or depression arising from family
problems. This issue might affect the health of the children adversely. Therefore, there is the
ISSUES IN CHILD MENTAL HEALTH POLICY
13
need to consider this factor when developing policies. Without preempting what could be done,
the policies must ensure stable care for youths that may be undergoing treatment for mental
issues. The approach is aimed at ensuring that the cases of recidivism are minimized. Family
relationships also affect the access to health care and medication.
Away from social and economic factors, it is necessary to consider the political approach
to such policies. Political approach to health care issues essentially involves the political factions
in the Congress regarding various policies. Here, the politicians who are situated in the Congress
are the leaders of the policy-making process. With the political disagreements on various
healthcare issues including the Affordable Care Act repeal attempts, political divisions may
cloud the process of policy-making. Therefore, in the development of policies, the numbers on
either side of the political divide matter. Policy presentation in the House and adoption mainly
depends on the political duel existing among the legislators. Therefore, the bottom line in
presenting policies that must be approved by the Congress is to ensure that the policies are
acceptable by the majority. On the contrary, this may jeopardize the credibility and efficiency of
the policies including slowing their adoption.
Statistics show that mental health care for children is underfunded. According to Primer
(2011), the spending for mental healthcare is easily diverted to other healthcare spending needs
due to the complexity of the system to source and account for funding. This shows a financial
factor to consider. Regarding the social factors involving racial disparities, Lau et al. (2012)
found out that racial minorities were three times less likely to access mental health care than nonHispanic whites in the U.S. these factors point towards the need to evaluate the methods that
policy development could be adopted to address children mental health care.
ISSUES IN CHILD MENTAL HEALTH POLICY
14
References
Garland, A. F., Haine-Schlagel, R., Brookman-Frazee, L., Baker-Ericzen, M., Trask, E., &
Fawley-King, K. (2013). Improving community-based mental health care for children: Translating
knowledge into action. Administration and Policy in Mental Health and Mental Health Services
Research, 40(1), 6-22.
Harper G. (2012). Child and adolescent mental health policy. In Rey JM (ed), IACAPAP eTextbook of Child and Adolescent Mental Health. Geneva: International Association for Child and
Adolescent Psychiatry and Allied Professions.
Lau, M., Lin, H., & Flores, G. (2012). Racial/ethnic disparities in health and health care among
US adolescents. Health services research, 47(5), 2031-2059.
Primer, A. (2011). Mental health financing in the United States. Kaiser Commission on
Medicaid and the Uninsured.
Purchase answer to see full
attachment