A Better Tomorrow for Children's Mental Health Depends on Today’s Actions

Most people don’t often associate mental health emergencies with children. Instead, people tend to believe children and adolescents are immune to depression, anxiety, loneliness, trauma, or severe mental health challenges. They simply don’t want to believe that pediatric emergency departments see a significant number of school-aged children at risk of suicide.

But that’s simply not reality. The truth is suicide is the second leading cause of death in 10- to 24-year-olds, and suicide attempts, ideation, and self-injury are among the most common mental health conditions seen in children’s hospitals’ emergency departments (EDs). These serious issues accounted for 31% of behavioral health encounters in children's hospitals EDs in 2023 alone, according to data from the Children’s Hospital Association’s Pediatric Health Information System®.

What’s more, unmet mental health needs in childhood can lead to crises in adolescence and young adulthood. According to the CDC, in 2021, 22% of high school students seriously considered attempting suicide, and one in 10 attempted suicide at least once during the past year.

These statistics reflect an escalating crisis and the urgent need for a comprehensive response. In 2021, Children’s Hospital Association (CHA) joined with the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry (AACAP) to declare a national emergency in child and adolescent mental health. As we reflect on the years since that declaration, we must acknowledge the path ahead is long, and our steps must be deliberate and sustained.

Addressing the youth mental health crisis has been a long-standing priority for CHA and children's hospitals across the nation. CHA joined forces with the Cardinal Health Foundation and the Zero Suicide Institute to create the Preventing Youth Suicide National Collaborative. Together with 30 children’s hospitals around the country, we are working to identify, assess, and care for children by screening those potentially at risk for suicide. Our early findings are a call to action: over a quarter of a million children and youth have been screened, finding 15% potentially in need of support and services who could have otherwise gone undetected. These figures represent children in urgent need of specialized supports, and timely access to a broad range of pediatric mental and behavioral health services. Catching kids early can prevent suicide.

In my role as CEO of CHA, I am compelled to draw upon the experiences of the children and families our member hospitals and health systems serve. The words of Kristin Stark, a parent patient advocate, capture what so many patients experience daily. “Imagine being in the middle of the worst crisis of your life. You pick up the phone to ask for help and are told your wait time for care is six months and insurance doesn’t cover it. That is the current reality we are living in and it is unacceptable,” she said.

Stories like this are a testament to the critical need for enhanced access to mental health services. They also serve as powerful motivators for the work we do, underscoring the importance of expanding our pediatric mental health infrastructure and workforce.

The Helping Kids Cope Act, a bipartisan effort led by Reps. Lisa Blunt Rochester (D-DE) and Brian Fitzpatrick (R-PA), offers a legislative pathway to address these needs. It represents a comprehensive approach to mental health, acknowledging that solutions must be as multifaceted as the problems they aim to solve. This legislation is poised to strengthen community-based services, enhance the pediatric mental health workforce, and invest in the infrastructure necessary to deliver quality care.

This legislation is a critical step forward, but it is just one of many needed to ensure all children have the opportunity to thrive. We must all examine the barriers families face when seeking mental health care for their children, including health insurance coverage. For example, Medicaid is the largest payer of mental health services for children, yet low reimbursement rates for pediatric providers hamper participation in the program, only exacerbating workforce shortages and contributing to delays in access to mental health care children need.

Mental Health Awareness Month provides a fitting backdrop to reflect on the progress made and the work that remains. It is a time to reaffirm our commitment to the mental health of our nation's youth and to transform our systems of care to better meet their needs.

Now is the time for a concerted effort from all sectors of society—health care providers, educators, parents, and policymakers—to rally behind this cause. By addressing the systemic issues that contribute to the current state of children's mental health, we can create a future where mental health support is accessible and prioritized in the same way as physical health care.

Let us come together to create a brighter, healthier future for all our children, ensuring they have the support they need to face life's challenges with resilience and hope. The actions we take today can improve outcomes tomorrow.

Matthew Cook is the CEO of the Children’s Hospital Association, the national voice of more than 200 children’s hospitals and health systems.