AAP members have warned that the pandemic has simply accelerated “[the mental health] problems that were already there.” By 2018, suicide had become the second-highest cause of death among children between the ages of 10 and 24; and according to AAP’s letter, there’s been a dramatic rise in emergency room visits for all mental health emergencies since the start of the pandemic.
In their 2021 study, Curfman and colleagues confirmed these sobering observations after revealing in their 2021 study that 1 in 4 parents included in their research sample noticed that children are experiencing worse mental health symptoms during the pandemic. The AAP supported this finding, citing the 140,000 children who have lost a primary or secondary caregiver in the United States from the pandemic—with children and communities of color being disproportionately impacted.
In the letter, specific recommendations were made, in part, to reduce racial inequities and to improve service outcomes. These included a need for local, state, and national initiatives that improve the quality of care in areas of “promotion, prevention, and treatment” to address the child mental health crisis. Some other objectives included in AAP’s declaration are to—
- Acquire sustainable funding for school-based mental health care models.
- Address regulatory barriers that threaten telemedicine services.
- Adopt integrated mental health care models for primary care pediatrics.
- Reduce the suicide risk for children through prevention programs.
- Increase federal funding for all families and children—especially those living in under-funded populations—to increase access to evidence-based care.
Progressive mental health legislation and financial support are necessary to meet these ambitious recommendations. While policymaking has not been known for its quick response time, many states have heeded the warning by executing emergency orders that expand access to telemedicine services. As of October 2021, The Federation of State Medical Boards has issued 18 state emergency waivers granting practice flexibility for out-of-state telemedicine practitioners. Although the fine print varies between states, this step toward access shows that medical boards are seeing how valuable telehealth can be.
But these emergency orders aren’t a stand-in solution for systemic resolutions. This is why the AAP is sticking to their message to counteract the decline in youth mental health. Advancing stronger legislation and evidence-based programs may bring the type of change that’s desperately needed.
American Academy of Pediatrics. (October 19, 2021). AAP-AACAP-CHA declaration of a national emergency in child and adolescent mental health. [Description: a letter from members of the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association describing how COVID-19 has affected the mental wellbeing of children.
Curfman, A., McSwain, D. S., Chuo, J., Yeager-McSwain, B., Schinasi, D. A., Marcin, J., Herendeen, N., Chung, S. L., Rheuban, K., Olson, C. A. (2021). Pediatric telehealth in the COVID-19 pandemic era and beyond. Pediatrics, 148(3). [Description: research article highlighting the state of telemedicine amid the COVID crisis and future modifications].
Federation of State Medical Boards. (October, 2021). U.S. states and territories modifying requirements for telehealth in response to COVID-19. Retrieved November, 17, 2021 [Description: a document showing telemedicine practice modifications during the COVID-19 pandemic].