AAP-AACAP-CHA: Policy Priorities to Improve Access to Mental Health Services for Children


On February 8, the Senate HELP Committee held a hearing on Mental Health and Substance Use Disorders: Responding to the Growing Crisis. The three founders of Sound the Alarm For Kids, The American Academy of Pediatrics (AAP), American Academy of Child and Adolescent Psychiatry (AACAP), and Children’s Hospital Association (CHA), outlined the following key points urging the committee to recognize the dire national emergency in child and adolescent mental health and put forward meaningful policies to address children’s emotional, mental and behavioral health needs:

The COVID-19 pandemic has exacerbated a pre-existing crisis in children’s mental health as young people face ongoing social isolation, uncertainty, fear, and grief. Even before the pandemic, mental health challenges facing children were of great concern – one in five children and adolescents experience a mental health disorder in a given year. Now, demand over the past 18 months for pediatric inpatient mental health services, partial hospitalization, step-down programs, and other levels of crisis care has risen significantly.

Despite sizable federal funds allocated to address mental health in multiple COVID-19 relief packages, pediatric providers report they are unable to access such funds due to very broad funding goals spread across multiple populations and the lack of specific designated funding to improve mental health care for children in their own practices and other health care settings. If thoughtfully designed and targeted to reach pediatric health care providers across settings, funding could be used to support the entire continuum of care for pediatric mental health and ensure our children and families can access care when and where they need it. Further, we must identify strategies that specifically address the unique needs of children from racial and ethnic minoritized communities and the added barriers they frequently face.

As the committee works to develop legislative solutions, we asked them to advance the following policy priorities that will result in improved access to mental health services for children from promotion and prevention through needed treatments:

  • Reauthorize the HRSA Pediatric Mental Health Care Access Program for five years at a level that allows HRSA to maintain all existing grantees and permits them to expand the scope of services offered including in schools and emergency departments.
  • Ensure SAMHSA funding adequately prioritizes children and the continuum of their needs.
  • Increase investments to support the recruitment, training, mentorship, retention, and professional development of a diverse clinical and non-clinical pediatric workforce, including funding for minority fellowship programs for mental health physician specialists.
  • Address low Medicaid payment rates for pediatric mental health services, ways to better support coordination and integration of care, and access to services in schools.
  • Direct CMS to review how EPSDT is implemented in states to support access to prevention and early intervention services, as well as developmentally appropriate mental health services across the continuum of care and provide guidance to states on Medicaid payment for evidence-based mental health services for children that promotes integrated care.
  • Dedicate support for the pediatric mental health system and infrastructure, which is currently woefully underfunded.
  • Facilitate access to mental health services through telehealth.
  • Ensure strong implementation, oversight, and proactive enforcement of the Mental Health Parity and Addiction Equity Act.