Behavioral health concerns are very common in every part
of this country. They include conditions like anxiety, depression, and other
mood disorders, along with substance use disorders. Despite their
prevalence, lingering stigmas and limited access mean people may not seek help
when they need it.
These conditions can impact people of all ages, including
kids – and the stats are heartbreaking:
- The Centers for Disease Control and Prevention (CDC)
reported 1 in 5 children are suffering from poor mental health, which has
worsened during the pandemic.
- The National Alliance for Mental Illness (NAMI) found
nearly 50% of youth with a mental illness didn’t receive mental health services
in the previous year.
- Families are 10 times more likely to
go out-of-network for pediatric behavioral health care due to lack of providers
or long wait times.
With the need for care reaching this level of crisis,
what is being done to help improve access for young people?
Taking the first step
Often, a parent or child will first bring up behavioral
health concerns with their pediatrician or primary care doctor.
Dr. Josephine Young, Medical Director at Premera Blue
Cross, worked as a pediatrician in various settings for more than 20 years.
“It starts with a conversation,” she said. “I would ask about
how things are going at school and with their friends, about their home and
family, how they feel about themselves and what concerns they might have. And
most importantly, how they would like to approach any issues that have been
identified.” She noted it’s
important to lay out the path for children to participate in their treatment
plan. Being empowered in their own healthcare helps ensure they engage in their
treatment.
Many kids may not regularly see a primary care doctor,
though. In that case, they may confide in a trusted adult in their life.
“Sometimes it’s talking to a family member, teacher, school counselor,
neighbor, or coach,” Dr. Young explained. “It’s about having as many adults in
the community as possible be receptive to having these conversations. You don’t
know when a child or teen will open up and to whom. As adults, we need to be
there for those moments.”
Finding help isn’t always easy
Once concerns are shared and a need for counseling is
confirmed, the next step is establishing timely care with an appropriate
therapist. However, it can be a daunting task for families to find a local
therapist who is a personality fit with the right clinical expertise or has
availability that matches their schedule. These hurdles frequently keep these
patients from the behavioral healthcare that is needed, sometimes leading to
emergency care in crisis.
Talking with a therapist is a very individual experience
and everyone’s needs are met differently. “Being able to talk to someone who
understands your background and culture or looks like you is significant,” Dr.
Young explained. “Many people feel that having to educate a therapist on their
perspective and lived experience is an added weight that doesn’t feel worth it.
This is a very real problem that’s worsened by a lack of options in clinicians.”
Finding the right fit can be even harder in historically
marginalized communities. According to a study by the American Psychological
Association, 86% of psychologists are white and other behavioral health
professions are similarly lacking in diversity. Plus, the American Journal of
Preventive Medicine found that 65% of rural counties do not have a psychiatrist
in the area and almost half do not have a psychologist.
As part of Premera’s commitment to closing gaps in access
to healthcare services, our Social Impact program has made significant
investments in organizations that are working to solve these continued issues
in Washington and Alaska. This has included grants to The Chief Seattle Club to
build a behavioral health clinic for American Indians and Alaska Natives, the
YMCA of Snohomish County to hire behavioral health specialists who equip kids
with skills to navigate intense emotions, and the University of Washington’s
AIMS Center to support mental health services across rural areas of Washington
and Alaska.
Premera has also
made health equity a strategic priority. To help drive more meaningful change
for our members, we’re focusing on inequities that persist for Black
Washingtonians, Alaska Natives, and rural communities across both states,
particularly around behavioral health and hypertension.
Closing the gap
Reducing the time between a young person asking for help
and getting into treatment, along with broadening provider options, can help
break down the barriers to accessing quality care.
“When a young person finally works up the courage to go
forward with therapy, you have to meet them where they’re at or you might lose
them. You really have to capture the moment,” Dr. Young shared. “It’s that much
harder if they are in a community where mental health is seen as a sign of
weakness or a personal shortcoming, so acting quickly is important.”
Integrating behavioral health services into primary care
clinics is one way to help shorten the amount of time it takes to meet with a
clinician. With therapists on-site, a pediatrician can promptly connect kids
with them in a familiar setting. This collaborative approach can ultimately
lead to better overall health outcomes, too, because behavioral health and
physical health are two halves of the whole health of an individual.
Virtual behavioral healthcare – sometimes called teletherapy
or telemedicine – can open many doors when it comes to access. For many, it’s a
faster and more convenient option. Kids don’t have to worry about
transportation to and from appointments. They can talk to someone when it works
for them and from wherever they are comfortable – whether it’s their bedroom or
a friend’s house. It also offers more opportunities to find the right fit,
especially for children who can’t easily find a therapist in their area who
looks like them or they see as relatable.
There are a few models of virtual care available. Many
doctors and therapists who work in physical offices started offering virtual
services. This gives kids the flexibility of virtual appointments with the
option to see someone in-person if needed. Premera includes several
virtual-only options in our network, too. Therapists and clinicians from across
the country can be part of these virtual platforms, offering a broad range of
backgrounds and experiences. This presents young people with choices that may not
exist in their local area due to a lack of providers.
The Premera provider directory offers the ability to
filter by providers who offer a telemedicine option. Check out website for more
details about the virtual-only
options, too.
Dr. Young shared an important tip for everyone,
especially those with young people in their lives. “If you encounter someone
who says, ‘I think I need help,’ then ask them, ‘How can I help? How can I
support you? Can I share this with anyone else?’” This is part of the important
feeling of empowerment that makes young people an active participant in their
care.
“I also want people to think about how amazing it can be
for young people to understand their challenging experiences and expand their
inner toolbox through therapy. By gaining these skills and insights, they can
better address future concerns as they arise,” Dr. Young said.