Advocates call for more work on youth mental health

Mental health services for Ohio children are in constant need of improvement, experts say.

Areas across the state are still hurting for access, they say, and need help giving kids what they need to respond to mental health issues and prevent them before they happen.

“Ohio has an opportunity to invest in children so that we can promote their well-being and prevent some of these (mental health issues) from happening,” said Kim Eckhard, research manager for the Ohio Children’s Defense Fund. .

Research by CDF-Ohio showed that Ohio lacks a uniform behavioral health care system, despite the fact that “20% of a child’s well-being can be affected by clinical intervention,” according to a 2021 report by CDF and the Mental Health and Addiction Advocacy Coalition.

Adverse childhood experiences (ACE) are among the risks that can affect children and create mental health problems that need intervention. ACEs, according to CDF-Ohio, are “strongly associated with the development of a wide range of health problems” and can include exposure to family dysfunction, violence and financial hardship within the family.

In 2021, Ohio ranked 46th in the nation for children having three or more ACEs, with minorities at the highest risk.

While Medicaid funds access to mental health services for children, transportation and lack of providers can create barriers to care.

Robin Harris, executive director of the Alcohol, Drug and Mental Health Board of Gallia, Jackson and Meigs counties, said all but four Appalachian counties in the state have been designated as “mental health professional shortage areas.” Only one “crisis stabilization facility” exists in Appalachia, in Gallia County.

“Bringing this structure to fruition was an example of good old-fashioned Appalachian determination,” Harris said, speaking to the bipartisan Ohio Legislative Caucus for Children.

However, children typically have to travel two hours or more to get to a mental health facility, with 14% of Appalachian families reporting that they do not have the means to do so.

Stephanie Starcher, superintendent of the Fort Frye Local School District, not only knows mental health struggles within her students, but also within her own family.

Starcher’s daughter suffers from severe mental health issues, and her family has had to travel two hours to get to Cincinnati or Columbus for proper care. Starcher said she, her daughter and her husband waited three days at a local emergency room awaiting transport to a facility.

She and her husband have missed work and her daughter has missed school to travel for care when telehealth services are not convenient.

“I keep thinking to myself,” Starcher said. “If I as an educator…have to do this to get our kid the kinds of services that he needs because (the services) aren’t in Appalachia, then what about the families that don’t have the education to overcome that I have?”

Fort Frye contracts with local behavioral health providers to staff social workers and counselors, who work with students after obtaining parental permission.

“I heard over and over from the agencies we worked with that it was very difficult to recruit workers in the area,” Starcher said. “Even though we have the funding to support clinical settings in schools, getting workers here is a big challenge.”

Appalachia has its share of problems, but Eckhart said the problem is not exclusive to Appalachia.

“Across the state in those rural counties, you might have 20 providers in the entire county,” Eckhart said.

Advocates want to see regional investments focused on behavioral health improvements, including funding from America’s Rescue Plan to get resources off the ground.

Randy Leite, executive director of the Appalachian Children’s Coalition, said the organization is conducting “needs assessments” in all 32 Appalachian counties.

But using federal ARPA funds to invest in mental health across the state, and promoting student wellness and success in schools for social and emotional learning — something parents have said should be a priority in education — are “extremely important”, according to Eckhart.

In May of this year, Governor Mike DeWine announced a “pediatric behavioral health initiative,” allocating $84 million in federal ARPA funds “to increase access to care and expand capacity across the state so that children and their families to be able to receive services and support for behavioral health needs in or near their communities,” according to an announcement about the initiative.

The funding was approved by the General Assembly in House Bill 168. $25 million of the funds went to Dayton Children’s Hospital, $17 million to ProMedica Russell J. Ebeid Children’s Hospital in Toledo, $15 million to Rainbow Babies & Children’s University Hospitals, $10 million to Cincinnati Children’s Hospital Medical Center and $7 million to Akron Children’s Hospital.

Appalachian Children’s Coalition Integrated Services for Behavioral Health was allocated $6.45 million and the coalition’s Hopewell Health Centers received $3.55 million in allocations.

Leite argued for multiple funding sources to cement resources in the state. He estimated that $20 million to $30 million would be needed in one-time funds to really get the services up and running.

“Because of the complexity, I think there’s a real need to think about all the funding sources available,” Leite said.

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