It’s the perfect post-pandemic storm: an increase in the number of children needing behavioral health care and a decrease in available physicians.
A survey conducted by the Association for Behavioral Healthcare found that children in the state are having to wait longer for behavioral health services. For example, families seeking home treatment with MassHealth (the state Medicaid program) have to wait an average of 20.5 weeks, and those with private health insurance wait even longer, with an average of 26.5 weeks for those types of services. Have to wait.
The survey says a shortage of physicians is hindering children’s ability to get behavioral health help.
A report released in December describing the survey results said Massachusetts has an impressive system of home and community-based mental health services for families with public and commercial health coverage, but the system exists only on paper. Children are suffering because we are failing to invest in services and the workforce.
The Association for Behavioral Healthcare is an organization that represents over 80 community-based mental health and addiction treatment organizations. Its survey, which it conducted in July, was responded to by 30 organizations running 208 sites across Massachusetts and found that at least 3,300 families were waiting to receive services at the end of fiscal year 2022.
Lydia Conley, president and CEO of the Association for Behavioral Healthcare, explained that if children are not given resources when they initially need them, children’s needs can become severe while they wait for care.
In response to the federal lawsuit Rosie D. v. Romney, the state created the Children’s Behavioral Health Initiative to provide services such as in-home therapy and behavioral health services for children with MassHealth.
In 2019, the same standard of services was required for people with private insurance, called Behavioral Health for Children and Adolescents. The Association for Behavioral Healthcare survey states that due to unclear guidelines from private insurance companies, families with commercial insurance have less incentive to accept, leading to differences in who accesses and receives CBHI services within the Commonwealth. A two-tier system has been created for this.
Meanwhile, the survey found that the number of children the system is treating has not returned to pre-pandemic levels.
To date, these services have remained underutilized due to low provider capacity. …The report says that by the end of May 2023, respondents reported that approximately 32% fewer children and families received these same services compared to pre-pandemic levels.
Salary is a factor for physicians, the survey said. Many of the services provided by the Children’s Behavioral Health Initiative are based in the home setting to include family members and caregivers. These appointments are often held on nights and weekends and present more complexities than in-office appointments, yet the salaries paid are significantly lower than in-office or remote physicians.
State officials have invested $70 million in the initiative through August 2023, but Conley said, raising wages is not enough to attract and retain workers.
As a result, approximately 756 staff positions remain vacant, and the program has closed due to difficulties in finding funding and staff. Between the 2019 and 2023 fiscal years, six in-home behavioral service programs, 15 clinical counseling programs and 17 in-home therapy programs have closed, the report said.
In addition to the state’s roadmap for behavioral health reform, the Association for Behavioral Healthcare provided specific recommendations for meeting the needs of families in communities. This includes providing sustainable rates for physicians, paying rate differentials for non-English services, eliminating provider referrals, investing in outpatient services, implementing loan repayment awards and scholarships to attract and retain physicians, and And it has been suggested to reduce unnecessary administrative work for physicians.
Katherine Magg, senior vice president of the Behavioral Health Network, confirmed that as one of the organizations that reported to the Association for Behavioral Healthcare survey and provides services to youth in both Hampden and Hampshire counties, the findings are accurate.
There has been an exodus of workers during the pandemic and it has been difficult to hire back, Maguire said. Children now come with more serious conditions than ever before. This is a real mental health crisis and with so many people needing it now it is harder to do the job.
If you or someone you know is looking for help, call or text the Behavioral Health Help Line at 833-773-2445.
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