Advocates are calling for more work on youth mental health

Mental health services for children in Ohio are in constant need of improvement, experts say.

They say areas of the state are still struggling to access and need help getting kids what they need to respond to mental health issues and prevent them before they happen.

“Ohio has an opportunity to invest in children so that we promote their well-being and prevent some of these (mental health issues) from happening,” said Kim Eckhardt, research manager for the Ohio Children’s Defense Fund.

Research by CDF-Ohio found Ohio lacks a unified behavioral health care system, despite the fact that “20 percent of a child’s well-being can be impacted by clinical intervention,” according to a 2021 CDF report and the Mental Health and Addiction Advocacy Coalition.

Adverse childhood experiences (ACEs) are among the risks that can affect children and create mental health problems that need intervention. ACEs, according to CDF-Ohio, are “strongly associated with the development of a wide range of health problems” and can include exposure to family dysfunction, violence, and family financial hardship.

In 2021, Ohio ranks 46th in the nation for children with three or more ACEs, with minorities at higher risk.

While Medicaid funds access to mental health services for children, transportation and lack of providers can create barriers to care.

Robin Harris, executive director of the Alcohol, Drug and Mental Health Board of Gallia, Jackson and Meigs counties, said all but four Appalachian counties in the state have been designated as “mental health shortage areas.” Only one “crisis stabilization facility” exists in Appalachia, in Gallia County.

“Making this facility happen was an example of good old-fashioned Appalachian determination,” Harris said, speaking to the bipartisan Ohio Children’s Legislative Caucus.

Still, children typically have to travel two hours or more to get to a mental health facility, with 14 percent of Appalachian families reporting they don’t have a vehicle to do so.

Stephanie Starcher, superintendent of the Fort Frye Local School District, recognizes not only the mental health struggles among her students, but also in her own family.

Starcher’s daughter suffers from severe mental health issues, and her family had to travel two hours to get to Cincinnati or Columbus for the proper care. Starcher said she, her daughter and her husband waited three days at a local emergency room awaiting transport to a facility.

She and her husband have missed work and her daughter has missed school to travel to receive care when telehealth services are not suitable.

“I keep thinking about myself all the time,” Starcher said. “If I as an educator…have to do this to get my child the services they need because (the services) aren’t in Appalachia, then what about the families who don’t have the education to jump through the hoops that’s what I have?”

Fort Frye contracts with local behavioral health providers to hire social workers and counselors who work with students after obtaining parental permission.

“I kept hearing from the agencies we worked with that it was very difficult to recruit workers in the area,” Starcher said. “Although we have funds … to support clinical settings in schools, finding workers here is a huge challenge.”

Appalachia has its share of problems, but Eckhart said the problem is not unique to Appalachia.

“Statewide in these rural counties, you can have 20 providers in the entire county,” Eckhart said.

Advocates want to see regional investments aimed at improving behavioral health, including funding from America’s Startup Rescue Plan.

Randy Leite, executive director of the Coalition for Appalachian Children, said the organization is conducting “needs assessments” in all 32 Appalachian counties.

But ARPA’s use of federal funds to invest in mental health statewide and the promotion of student health and success funds in schools for social and emotional learning — something parents said should be a priority in education — are “extremely important,” according to Eckhart.

In May of this year, Governor Mike DeWine announced a “Pediatric Behavioral Health Initiative,” awarding $84 million in federal funds to ARPA “to increase access to care and expand capacity across the state so children and their families can receive services and support for their behavioral health needs in or near their communities,” a release for the initiative said.

The funding was approved by the General Assembly in House Bill 168. $25 million of the funds went to Dayton Children’s Hospital, $17 million went to ProMedica Russell J. Ebeid Children’s Hospital in Toledo, $15 million to Rainbow Babies & Children’s University Hospitals, $10 million to Cincinnati Children’s Hospital Medical Center and $7 million for Akron Children’s Hospital.

The Coalition of Appalachian Children’s Integrated Behavioral Health Services was designated $6.45 million, and the coalition’s Hopewell Health Centers received a $3.55 million allocation.

Leite argued for multiple funding sources to cement resources in the state. He estimated it would take $20 million to $30 million in one-time funding to really get the services up in the air.

“Because of the complexity, I think there really is a need to think about all the funding sources that are available,” Leite said.

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