WILMINGTON, Del. — Mental health providers need more incentive to stay within the health insurance system instead of requiring patients to pay for treatment out of pocket, a Delaware private health system official said here Monday. .
“How do we incentivize providers to stay out of the self-pay space to work more closely with organizations and associations that allow people with different insurance to participate?” Erin Booker, LPC, vice president of community health and engagement at ChristianaCare, at a roundtable on youth mental health sponsored by Nemours Children’s Health. “Unfortunately we are experiencing in Delaware that many people go into private practice and make the decision not to purchase insurance because that process is so complicated.”
Rep. Lisa Blunt Rochester (D-Del.), who also attended the roundtable, said often people don’t even consider becoming a therapist in the first place. “We’ve worked on legislation that has focused on everything from incentivizing that training and giving money and support … and also the infrastructure piece, making sure that organizations like children’s hospitals have the support that they need to be able to not only get the workforce, but build even the beds and the spaces, because that’s also a necessary component.
Amy Knight, president of the Association of Children’s Hospitals, noted that “we have 75 million children in this country, 20% of them require mental health support, but only 20% of [those] get it because we don’t have enough of those providers.
The federal government “can invest in training programs, not just for psychiatrists and psychologists, but also for those of many other [mental health] professions as well… And we don’t just need to train them, we need to pay them once they’re trained, making sure mental health parity is there along with health parity,” Knight said.
Andrew Celio, a rising senior at Caesar Rodney High School in Camden, Delaware, and president of Delaware Educators Rising, spoke about his own mental health struggles, explaining that even after middle school counselors figured out how was dealing with their difficulties, “they provided me with weekly scar checks, instead of giving me the advice I needed, due to lack of resources.” He was eventually able to get counseling and said that his counseling “is the reason I’m here today.”
“I urge you to address the mental health crisis and the crisis that providers are experiencing right now, and the shortage of mental health providers,” Celio told lawmakers at the roundtable. “I need you to address the barriers with insurance and remove the stigma against mental health and mental health providers.”
Sen. Chris Coons (D-Del.) said he supported a bill that would allocate $375 million for postgraduate medical education training at children’s hospitals, adding that he and Sen. Joni Ernst (R-Iowa) “are working in a specific program for NIH pediatric research.
“The NIH has gotten more and more funding year after year, but the amount of money dedicated to pediatric medical research has actually gone down,” Coons said. “We need to change some of that direction because we need the training that comes from major clinical research work and we need the funding for postgraduate medical education.”
Delaware State Representative Valerie Longhurst (District D-15), who is also the Majority Leader of the Delaware House of Representatives, described her own family’s mental health issues: “When I was a child, my mother tried commit suicide twice,” he said. “And you can’t ask Andrew or someone else to go to school and sit in a classroom and learn what the capital of Delaware is when you have your own problems in your life.”
Longhurst said that 7 years ago, he launched a program in all Delaware schools “where every teacher and administrator would have to take a course on suicide prevention, and that was huge for me, because it wasn’t just about teachers, but everyone in the school would have to go through it in order to find those signs and get help.
However, in passing that law, “I discovered that 86% of elementary schools did not have social workers in their schools. That blew my mind,” he said. “I don’t know how we expect to have children if we don’t provide them with services.” So she sponsored a bill in the state legislature — signed by the governor last August — which established mental health units in the state’s public elementary schools at a ratio of 250 full-time students for every full-time school counselor or social worker, and a ratio of 700 students full-time equivalent students for the employment of a full-time school psychologist.
Those ratios, while “still not good enough for me,” Longhurst said, adding that when he talks to school counselors and school psychologists, “they ask me, ‘Who do I serve first? Do I serve the child who has been sexually abused, or do I serve a child whose father just attempted suicide? Who do you decide gets that service first?'”
He is now working on a similar staffing bill for middle schools and intends to introduce legislation for high schools as well.
Investing in these mental health resources early in a child’s life pays off in the long run, said Delaware Lieutenant Governor Bethany Hall-Long. “This week, I will be sitting in a room for our Board of Pardons, and 89% of those who preceded me…were minors who experienced ACE [adverse childhood events] and trauma,” he said. “It’s invest now or pay later.”
Health and Human Services Secretary Xavier Becerra, who also attended the event, said at a later news conference that his message to children was “we want them to grow up, enjoy their childhood, become great Americans… We want to be over there”. , we want to catch you, we want to nurture you and watch you because we’re learning how to do better.”