Moving the Needle on Mental Health

Getting children the help they need

It’s an astounding statistic: mental health problems affect one in every five young people at some point in their youth, according to the National Mental Health Association. Yet in the U.S. an estimated two-thirds of all young people with mental health problems are not receiving the help they need. What is getting in the way of treating mental health? One big factor is access.

It is estimated that 30 percent of individuals referred for mental- health services within the private-insurance sector either never make it into treatment or do not finish treatment. 

Because of the lack of access to convenient and timely care, all too frequently many people end up in a psychiatric crisis that can result in the need for hospitalization or residential care. It is an outcome that is more traumatic for the individual, and far more expensive and complex than would have been the case if they had been able to get conveniently located and easily accessible health services in the first place. 
The problem is so severe that the Office of Disease Prevention and Health Promotion’s Healthy People 2020 initiative has chosen to make improving mental health care access for children a primary priority. 

Over the past few years, we’ve made some progress in access to services for low-income individuals and families. 

For example, government contracts require outcome tracking to ensure that services are delivered at a place and time that do not interfere with school or work. Private insurance, on the other hand, typically does not include external oversight; carriers are not required to report out on outcome data — those are the kids falling through the cracks.

Mental health has become an epidemic, particularly among the young, and it’s costing lives. According to the World Health Organization, suicide is the second-most-common cause of death in teenagers and young adults age 15 to 29. 

Alameda County has already started work on suicide prevention and other mental health issues. Supervisor Wilma Chan’s office is sponsoring the Let’s Talk Alameda! Campaign that is due to launch this fall, and there are other initiatives locally as well as state- and nation-wide aimed at addressing mental health.

But while these campaigns are a great start, they don’t go far enough. To anyone who looks at the social-outcome data accumulated over years of research in the public sector it is obvious that both individuals and the community benefit from easily available services that are home-based rather than clinic or hospital based, regardless of whether payment is made by a government agency or a private insurance carrier. 

As a multi-decade long health care professional, I think it is time that our society begins to prioritize wellness over corporate profit.  Why aren’t we delivering services in ways that work for the individuals who are struggling with mental health issues? This, I suggest, must become a central part of the healthcare conversation in Alameda County. 

Suicide Prevention Week ended last Saturday. I hope that starting this week we can truly make some headway in reducing the number of people who die by suicide through simply improving their access to mental-health services.


Katherine Rowland Schwartz is the executive director of Alameda Family Services.