New England states strive to address impact of pandemic on adolescents

Pandemics tend to exacerbate mental health issues. At least, in our experience, this one has.

The first year of the pandemic saw a quadruple increase in adults reporting symptoms of anxiety or depression according to the Kaiser Family Foundation, with negative impacts on sleeping, eating, alcohol consumption or substance use, and worsening chronic conditions.

It’s a trend that holds true for adolescents as well. According to the Centers for Disease Control and Prevention, a reported 37 percent of high school students experienced poor mental health since the start of the COVID-19 pandemic, with 44 percent saying they felt persistently sad or hopeless during the past year. The CDC also reports that among children ages 10 to 14, suicide is now the second leading cause of death.

“We are definitely seeing an increase in kids seeking outpatient care and being seen by primary care,” said Cynthia Whitaker, Psy.D, president and CEO of Greater Nashua Mental Health and a member of the NH Children’s System of Care Advisory Council.

Across the region, there has been movement towards addressing the increased need.

“We take these concerns seriously,” said Ashley Gingerella O’Shea, director of strategic communications for the RI Office of Health and Human Services, “and have taken many steps to address youth mental health challenges.”

Many of the programs involve school-based mental health initiatives such as suicide prevention programs, training and screening for teachers, staff, and corrections officers who work with schools, and increased funding for school-based mental health services.

“Many of our kids in underserved communities don’t have enough access to care and so many families look to the school districts to provide behavioral health care to their kids,” said Sherry Kelly, Ph.D, co-chair of the Connecticut Psychological Association’s Child and Family Committee.

In Massachusetts, the legislature appropriated funding for a pilot program for telebehavioral health services through schools and passed a bill to create a council to advise the state on implementing a school-based system of behavioral health promotion, prevention, and intervention services.

In Rhode Island, the state has been working to build a children’s behavioral health system of care, create a family crisis plan, and raise awareness of issues for youth through social media and a public campaign on prescription drug safety. The state is beginning a plan for implementing a mobile crisis plan to keep children and youth out of the ER.

The state of Maine enacted a law that allows students to take mental health days off from school as excused absences. In a state with higher than average rates of depression and anxiety among adolescents, the law’s supporters claimed it would help fight stigma around talking about mental health.

In New Hampshire, the pandemic added to a situation that had been deteriorating for years and was being addressed by a System of Care law passed in 2016 that required the state to develop a comprehensive mental health delivery system for children.

“For New Hampshire, we were a little bit behind the game already,” said Whitaker, “so we had already been doing a lot of work since 2016.”

The state recently took over a privately-run youth psychiatric hospital and is expanding recovery services for youth with a collaborative program that involves peer support services and clinical services.

In Connecticut, the legislature has passed a bill to expedite the process of waiving licensure requirements for certain behavioral health care providers for children and an act designed to expand behavioral services for preschool-aged children.

“These are two very important bills,” said Marcy Russo, PhD,  CPA legislative chair. “Both offer the opportunity for increased access, a real issue here in Connecticut, and nationally.”

In Vermont, there has been much movement towards addressing the issues. For example, the Department of Mental Health (DMH) has taken steps to expand suicide prevention training with community mental health centers and to initiate training for non-mental health professionals to recognize signs of suicidal ideation with the Agency of Education (AOE).  Plans are underway to conduct a mobile crisis needs assessment and to expand youth mental health first aid training.

“Data has shown an increased need for mental health services in Vermont. There have been many reports from individuals who are waiting weeks, or months, to find a provider with availability,” said Alexander Raeburn, communications and outreach coordinator for the Department of Mental Health.  “Much of the focus of DMH has been on stabilizing existing programming and providers to ensure necessary mental health supports could continue to be available for children, youth, and families across all levels of care.”