How health insurance coverage affects children’s access to mental health care – KTVZ


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How health insurance coverage affects children’s access to mental health care

The psychologist takes notes during the therapy session.

According to the American Academy of Pediatrics, emergency rooms see nearly 500,000 children with mental health issues each year, and that number is growing.

A 2019 paper by researchers at the University of Michigan showed that children ages 6 to 17 have an increasing need for mental health services, with one in six children reporting at least one mental health disorder. That was before the COVID-19 pandemic, which has hit children’s mental health hard. An increasing number of high school students report persistent feelings of sadness or hopelessness. According to the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey, 42% of high school students experienced these feelings in 2021, an increase of 5 percentage points from 2019 and an increase of 14 percentage points from 2011.

Yet about half of young people who need professional mental health services don’t get them, according to Michigan researchers. One of the barriers to children getting mental health care: health insurance coverage.

CounselingSchools.com uses data from the Kaiser Family Foundation to explore why insurance doesn’t guarantee mental health coverage and the differences for teens covered by Medicaid versus private plans.

Even though the law requires equal coverage for mental and physical health, getting the help your children need to get coverage can be difficult for parents. Historically, health insurance companies have rarely offered mental health benefits. In 1996, a federal law introduced the idea of ​​including mental health services to the same extent as physical health services, but it did not apply to all health plans. This concept expanded with the introduction of the Mental Health Parity and Addiction Equity Act of 2008, which required insurance companies to treat mental and physical health coverage similarly.

Still, NPR reports that insurance companies are often lax in ensuring equal coverage of mental health care, often treating mental illness as an acute illness rather than a chronic condition that may require long-term care.

The Kaiser Family Foundation reports that these laws apply to most health plans, but there are several exceptions. NPR reports on an example in which an Ohio family had to pay $40,000 for their daughter’s hospitalization for chronic suicidality after her insurance company stopped covering it. The family eventually made it through the red tape, continued treatment and received reimbursement for the costs.

Schools try to provide support as untreated mental health problems can harm pupils’ learning and development. The Substance Abuse and Mental Health Services Administration found in 2019 that 15% of teens received mental health services in school. But this is not enough to meet demand.



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How does Medicaid children’s mental health coverage differ from privately insured children’s mental health coverage?

The map shows that nearly 40% of American children are covered by Medicaid. In New Mexico, Arkansas and Louisiana, more than half of minors rely on Medicaid for coverage.

According to KFF, Medicaid and the Children’s Health Insurance Program (CHIP) provide a wide range of comprehensive mental health services to youth under 21 on Medicaid and youth under 19 on CHIP through early and regular screening, diagnosis and treatment benefits .

Under this benefit, young people can receive screenings for mental health, behavioral health and developmental issues, as well as physical health screenings, and receive any services needed to treat any mental and behavioral diagnosis, even if the services are not covered by state Medicaid. The benefit allows teens on Medicaid to receive better, more comprehensive mental health services than those covered by commercial insurance, according to the Commonwealth Fund.

Many states are using Medicaid to help children through school services. Twenty-one states have enacted laws extending Medicaid to cover school health care, including mental health services. For example, teens covered by Medicaid in Colorado can receive mental health services without a formal diagnosis, allowing for more early intervention, according to Education Week.

Story edited by Jeff Inglis and Kelly Glass. Copy edited by Tim Bruns.

This story originally appeared on CounselingSchools.com and was produced by
Published in partnership with Stacker Studio.


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