One year since AAP declared mental health crisis: What's changed?

Lisa Hunter Romanelli, PhD, CEO of The REACH Institute, outlined what has been done to address the mental health crisis in children and what still needs to be done.

The federal government has put $300 million into funding for school-based mental health services and community mental health clinics, both of which Hunter Romanelli considered to be great developments toward tackling children's mental health. Also, the US Preventative Task Force made another important step in addressing mental health by issuing guidelines on screening anxiety in children aged 8 to 18 years.

Structural racism was defined as a contributor to the crisis. To address this, the House of Representatives passed the Pursuing Equity in Mental Health Act, meant to address racial and ethnic disparities in mental health. While the Senate has not passed the bill yet, Hunter Romanelli considers the bill getting through the House to be promising, but has noted there is much more that needs to be done.

The mental health crisis was brought to public attention during the COVID-19 pandemic. Romanelli discussed how COVID-19 contributed to the crisis.

"COVID exacerbated an existing crisis in children's mental health," Hunter Romanelli said, noting that 1 in 5 children were estimated to have suffered from mental health even before COVID-19. Organizations such as The REACH Institute focused on addressing these issues prior to the pandemic.

During the COVID-19 pandemic, children were at home, increasing contact between parents and children. Hunter Romanelli stated this allowed parents and caregivers to notice the effects mental health issues had on their children. She believes this led to increased recognition toward mental health in children.

Unfortunately, Hunter Romanelli said, few systematic efforts have been made to support children who lost parents during the COVID-19 pandemic, despite new statistics saying over 200,000 children lost a parent because of COVID-19. Currently, there is no method of identifying these children in the United States.

Hunter Romanelli stated that more needs to be done to address this issue, but individual providers can help children by recognizing children's grief and talking to them about what happened and what they need. A webinar has been posted on REACH's website about helping children deal with loss and grief.

According to Hunter Romanelli, training more primary care providers in how to diagnose, and treat children’s mental health issues would improve the children’s mental health crisis further. Pediatric care providers are a valuable resource for children, and the more comfortable they are addressing mental health issues in their practice, the more children can receive help.