For nearly two years, the COVID-19 pandemic has put tremendous strain on our nation, including our youth. While children ages five and older can now be vaccinated and feel more protected against the virus, the reality is that the mental health impact of the pandemic will continue to plague kids and teens well into the future.
Alarmed by this reality, the pediatric community declared a national mental health emergency for children and adolescents back in the fall. And just last week, Surgeon General Vivek Murthy issued an urgent advisory that calls out the situation as critical and in need of immediate action.
With emergency room visits for suicide attempts increasing by 51 percent for young girls, and 4 percent for boys between 2019 and 2021, we must act now at the federal level to better support the continuum of kids’ mental health needs from promotion and prevention to early intervention and treatment to crisis care that is trauma-informed, culturally sensitive and provided by a workforce that reflects the diversity of the populations served.
As three organizations dedicated to the health and well-being of children and teens, we have seen firsthand the devastating effects of COVID-19. Nearly 7.2 million children have tested positive for COVID-19, representing 17.2 percent of all diagnosed U.S. cases. More than 140,000 children have lost a caregiver during the pandemic, and research shows children of color bear a disproportionate burden of COVID-19’s overall impact on kids.
That stress, anxiety and grief, coupled with the lack of routine kids rely on, has exacerbated the ongoing mental health crisis. We witnessed the national suicide rate among teens and young adults ages 10 to 24 increase 57 percent from 2007 to 2018. In the first half of 2021, children’s hospitals reported cases of self-injury and suicide in children ages 5 to 17 at a 45 percent higher rate than during the same period in 2019. Kids may be resilient, but it can take years to recover — and it’s time we stop failing our next generation.
Unfortunately, we are also facing a critical shortage of services to proactively address kids’ mental health issues. An estimated 15 million children and teens are in need of care from mental health professionals, but there are only approximately 8,300 child and teen psychiatrists nationwide, and 43 out of 50 states are experiencing a severe shortage across many pediatric mental health professions. Nearly 3 million kids do not have access to a school-based mental health professional, such as a school psychologist, counselor or social worker.
Pediatric primary care providers are uniquely suited to address the mental health needs of children, but often lack the training, support, or financial ability to provide behavioral health services in their clinics. In practical terms, that means kids — amid their social and emotional development — are waiting longer for help, which in turn makes treatment more complex, expensive and draining for a health care system already struggling to cope.
We cannot discount the strain our health care system has undergone throughout the pandemic and the consequences this has for patients. The National Institute of Mental Health estimates that nearly half of U.S. teens ages 13 to 18 now have at least one behavioral, mental or emotional disorder. At a congressional hearing in September, Dr. Margaret Rush, president of the Monroe Carell Jr. Children’s Hospital at Vanderbilt, testified, “Combined with the ongoing and high demand for acute mental health services, our capacity is strained, and we are very concerned about meeting children’s health care needs now and in the future.”
Many adults in the United States have already been vaccinated against COVID-19, protecting them from worse symptoms if they are infected, allowing them more freedom and ability to go about their daily routines, and freeing up valuable health care resources. Further, emerging data from the National Institutes of Health suggests vaccination is associated with reduced distress and perceived risks of infection, hospitalization and death.
Although 51 percent of those ages 12 to 17 are fully vaccinated, extending this protection and reassurance to children as young as five will go a long way in steadying their mental well-being, getting them back to their normal lives and ensuring trained professionals are still available for the kids who need them. As trusted experts and advocates in the pediatric community, we embrace vaccines for kids, and stand at the ready to counsel, educate and work to protect the children and families we serve.
While vaccines will help more children safely return to activities and experiences they’ve been missing during the pandemic, vaccination will not solve children’s mental health crisis. COVID-19 has been a reckoning, revealing the heartbreaking — and deadly — impact of persistent gaps in mental health services that have gone unaddressed for too many years for children and teens. We have an opportunity to re-chart the course. As we look toward a return to normal daily life, Congress must pass dedicated funding to build our nation’s mental health infrastructure and guarantee the resources today’s kids need to grow into healthy, thriving adults. When it comes to their mental health, and our nation’s future, we are sounding the alarm. There’s not a moment to waste.
Amy Wimpey Knight is the president of Children’s Hospital Association, representing over 220 hospital organizations and pediatric programs dedicated to improving child health through innovation in policy and care delivery.
Lee Ann Savio Beers is the 2021 president of the American Academy of Pediatrics, and is a professor of pediatrics and the medical director for Community Health and Advocacy at Children’s National Hospital.
Gabrielle A. Carlson is the president of the American Academy of Child and Adolescent Psychiatry, as well as a board-certified child and adolescent psychiatrist at Stony Brook Medicine and professor of psychiatry and pediatrics at Stony Brook University School of Medicine.
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