Opinion: What California can do to improve children’s mental health

California’s children are struggling. Unprecedented levels of toxic stress and trauma stemming from the pandemic have exacerbated a pre-existing crisis in children’s mental health.

Even before the pandemic began, rates of adolescent suicide and self-harm were on the rise. Now, nearly two years into the pandemic, social isolation, emotional disconnection, economic stress and COVID’s physical impact have taken a toll on our youth and exacerbated an already critical problem.

The Little Hoover Commission, California’s independent government watchdog, calls on the state to strengthen its system for supporting children’s mental and emotional well-being. The state must name an accountable leader, set clear goals, encourage coordination and employ schools as key sites to help kids.  This will ensure the state uses funds dedicated to children’s mental and emotional well-being efficiently and in a way that has the most impact, both short- and long-term.

COVID has had a uniquely piercing impact. It has been a major cause of stress and anxiety while pandemic-related safety measures – including social distancing and remote learning – cut many children off from their usual sources of support.

Chronic stress is affecting many children’s ability to regulate emotions and behaviors, pay attention, and start and complete tasks. Educators are seeing this first-hand.

As many children returned to in-person learning this fall, school districts reported soaring rates of absenteeism and surges in student misbehavior. Even worse, in early 2021 emergency department visits for suspected suicide attempts were almost 51% higher among adolescent girls and 4% higher among adolescent boys compared to the same time period in 2019.

Major national organizations declared a state of emergency in children’s mental health this fall. The U.S. surgeon general released an advisory last month with recommendations for supporting children amid the mental health crisis.

But California has long struggled to adequately support children’s mental and emotional well-being.

Its system for supporting children’s mental health contends with a slew of systemic barriers – including decentralization and workforce shortages – that prevent children from accessing much-needed mental health services. In 2018, California ranked 48th nationally for providing mental health services to children.

Moreover, accessing care is often most challenging for youth from minority and low-income communities, who have also borne the brunt of the pandemic’s impacts.

The good news is that Gov. Gavin Newsom and the Legislature have taken critical steps to improve California’s system for supporting child mental health. Last year, they established the Children and Youth Behavioral Health Initiative – a $4.4 billion investment in developing a comprehensive system of mental health care for Californians from birth to 25 years of age.

In our report, COVID-19 and Children’s Mental Health, the commission calls for additional reforms to ensure that the behavioral health initiative achieves its potential:

First, establish a single point of overall leadership for children’s mental health. This statewide leader should be tasked with creating clear plans for coordinating and implementing the Children and Youth Behavioral Health Initiative.

Second, set clear outcome goals. The state should establish goals for children’s mental health based on key metrics related to overall mental well-being, access to care and quality of care.

Third, promote coordination around children’s mental health care and services. The state should increase the support and technical assistance it provides to counties, health plans and other mental health providers. By cultivating a culture around collaboration and support, state and local governments can work better together to advance statewide goals.

Finally, center schools as sites for supporting child mental wellness. The state should encourage schools to develop comprehensive plans for coordinating student mental health services, using and sharing data, and integrating new and existing funding to create sustainable mental wellness programs.

Pedro Nava is chairman of the Little Hoover Commission. Sean Varner and David Beier are members of the commission’s subcommittee studying economic recovery from the pandemic. They wrote this commentary for CalMatters.