Mental health is essential to overall health. This is why the Obama Administration is committed to improving mental illness prevention and treatment. The early years of life set the stage for life-long mental health; with half of all lifetime cases of mental and substance use disorders beginning by age 14 and three-fourths by age 24. Currently, about 1 in 5 youth are experiencing a mental or substance use disorder.
Research has shown us that intervening early at the individual, family, and community level can delay or prevent the on-set of mental and substance use disorders. We also know that mental and substance use disorders can be treated, and individuals with these conditions can lead healthy productive lives. Yet, today, fewer than half of children and adults with diagnosable mental health problems receive the treatment they need.
That is why the Affordable Care Act is so important to mental health. The health care law, along with parity legislation, will expand mental health and substance use disorder benefits and parity protections for 62 million Americans. And, it ensures that individuals in new health plans have access to a range of recommended preventive benefits at no cost, including depression screening for adolescents and adults and behavioral assessments for children. All new small group and individual private market plans will be required to cover mental health and substance use disorder services as part of the health care law's Essential Health Benefits categories, and mental health benefits will be covered at parity with medical and surgical benefits. Also in 2014, insurers will no longer be able to deny anyone coverage because of a pre-existing mental health condition.
The Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA), along with our partner agencies within the Department of Health and Human Services, are working closely to ensure that individuals and families learn about and benefit from the health care law.
Understanding Children's Mental Health Needs
Data are essential to our work and to helping us understand children's mental health needs, who is affected, how they are affected, and what we can do about it. On May 16th, CDC, in collaboration with SAMHSA, the Health Resources and Services Administration and the National Institute of Mental Health released a first-of-its-kind comprehensive data report on mental health and children. CDC and SAMHSA collect critically important data about mental health, including information on specific conditions, health care access and needs, health risk behaviors, health outcomes and school health. This new report marks our effort to integrate this data in a meaningful way to better understand children's mental health needs and assess our progress going forward. It describes the number of U.S. children aged 3-17 years who have specific mental disorders or indications of mental health, using information from different data sources collected in 2005-2011.
Among its findings are:
•Mental disorders affect children of all race/ethnicities, genders, ages and regions of the country.
•The number of children with a mental disorder increases with age (except those with autism spectrum disorders)
•Attention-deficit/Hyperactivity Disorder was the most prevalent parent-reported current diagnosis among children aged 3-17 years (6.8 percent)
•Boys were more likely to have most of the conditions reviewed compared to girls, including ADHD, behavioral or conduct problems, autism spectrum disorders, anxiety, Tourette Syndrome, and cigarette dependence.
•Adolescent girls were more likely to have depression, and alcohol use disorder.
Supporting Prevention
Promoting optimal health, including mental health, in early childhood is associated with positive health and life outcomes. This is why, in addition to supporting coverage expansion through the health care law, HHS is committed to promoting early identification of mental health conditions and referral to treatment, mental health research, and community-based prevention and support.
The President's Fiscal Year (FY) 2014 budget proposes a new $130 million initiative to access to mental health services, including:
•Project AWARE (Advancing Wellness and Resilience in Education) isan initiative to reach 750,000 young people and make sure those with mental health issues or other behavioral issues are identified and referred to the services they need. This includes Mental Health First Aid training for teachers and other adults who interact with youth to detect and respond to mental illness in children and young adults, including how to help adolescents and families experiencing these problems to seek treatment.
•A program to support innovative state-based efforts to help young people at high risk for mental illness transition to adulthood. This program will help ensure that these young people and their families are not lost or isolated during this critical time in their lives, in order to help prevent potential disabling effects of mental illness.
•Funding to support training of 5,000 more mental health professionals with a focus on serving students and young adults. This includes training more social workers, counselors, psychologists, and other mental health professionals
The FY 2014 budget also maintains support for the millions of Americans who already have mental health coverage through Medicaid. Medicaid is currently the largest funder of mental health services in the country. In addition, the FY 2014 budget will support approximately $2.3 billion in mental health research funded by several NIH Institutes and Centers. The budget funds research that aims to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure.
In addition, CDC and SAMHSA are supporting ongoing initiatives to prevent, identify and respond to mental health issues among young people, including:
•"Learn the Signs. Act Early.": a CDC program that gives parents tools to help identify children with social, emotional or behavior delays--with the intent of early diagnosis and treatment.
•Public Health Practice and Resource centers that provide evidence-based information to parents, health providers and educators to improve the health and educational outcomes for individuals with ADHD or Tourette's Syndrome.
•State Policy Academy on Preventing Mental and Substance Use Disorders in Children and Youth: a SAMHSA program that works in collaboration with CDC and Indian Health Services to assist states in building the infrastructure needed to help prevent mental, emotional, and behavioral health problems and disorders, with a focus on children and young adults from birth to age 24 years.
•Prevention Practices in Schools (PPS): a SAMHSA pilot program that supports schools with tools to help improve classroom behavior and focus on long-term goals such as reducing substance use and improving graduation rates.
•Preventing youth suicide. CDC and SAMHSA are working with a variety of organizations to implement and evaluate effective strategies and provide education that promote wellness and help prevent suicide and related behaviors.
•CDC evidence-based primary prevention approaches like the Legacy for Children™ Program. These programs help parents understand and respond to child development.
CDC, SAMHSA and our partner agencies will continue our important work to better understand mental and substance use disorders and implement prevention strategies so children can reach their full potential and become adults who are healthy and fully engaged in their communities.
Dr. Tom Frieden is the Director of the Centers for Disease Control and Prevention
Pam Hyde, JD; is the Administrator of the Substance Abuse and Mental Health Services Administration