​"Navigating the multiple systems of care to receive mental health services is complex and can be daunting"​

D. Imelda Padilla-Frausto, is a researcher at the Center and lead author of a new policy brief on lack of treatment among young children who need mental health care. In this brief interview, Padilla-Frausto discusses what barriers keep children from getting mental health care and why having insurance hasn't helped, how coordinated care could increase the number of children treated and what can be done to better to ensure mental health care for children.

Q: Although 95 percent of children in need of mental health care have health insurance, most don’t receive help. What may be some barriers preventing parents of insured children from accessing services?

​There are many barriers, and some are related to whether a family has private or public health care coverage.

For people with private insurance, studies have discussed the lack of health care coverage for mental health problems. This places a huge financial burden on families to pay out of pocket. For those in public health care, reports suggest that navigating the multiple systems of care to receive mental health services is complex and can be daunting, which deters and delays families and children from receiving timely care. And some people may not know whether their coverage includes mental health care or not.

About 15 percent of Californians live in areas where there is a shortage of mental health professionals. These shortages result in long wait times or long commutes to be seen and treated which may discourage or prevent parents from seeking services for their children.

And while most of these children with mental health needs have a usual source of care, there could be a lack of mental health screening taking place at well-child or sick-child visits, and there may be a lack of mental health training among physicians to identify mental health problems. On the other hand, physicians may be screening for and identifying mental health problems among children but facing barriers in getting their young patients timely care due to a shortage of mental health professionals and long waiting lists or there may be a lack of coverage by health plans.

Finally, stigma may also be a contributing factor to seeking mental health treatment.

Q: Your study hints at a lack of coordination between medical professionals -- does there need to be a one-stop health care group where a child can go for physical and mental care?

​Yes, I do believe it would be beneficial to have something like a medical home where coordinated and integrated care is provided. This may increase the number of children being treated. For example, one report found that a higher percentage of children received mental health care under a Kaiser health plan, compared to other health plans, because Kaiser’s mental health services were under one coordinated system, making it easier on families.

Integrated and coordinated care where mental health professionals are embedded in medical settings could address some of these issues. Lack of coverage by health plans could be addressed with better implementation of mental health parity laws.

Q: What can we do better to ensure that children are getting the mental health care they need?

​​Right now, we’re focused more on the treatment of mental health disorders – we’re coming in after the fact. Treatment is important, but intervening early should become a focus as well. To safeguard children’s mental well-being, a public health approach is needed to promote well-being and prevent mental health problems before they happen.

Read the policy brief: Three Out of Four Children with Mental Health Needs in California Do Not Receive Treatment Despite Having Health Care Coverage