How Payers Can Improve Mental Healthcare for Children

By Sarah A. Peipert, RN, MBA, Vice President, Population Health, Clinical Operations, and Behavioral Health Solutions, Centene Corporation

Approximately 1 out of 5 children in the US experience a mental disorder. The lasting effects of a mental health condition, if not acknowledged and treated, can continue through one’s lifespan and result in difficulties in school, forming relationships, and the ability to gain and keep employment later in life. Prevention, access, and quality treatments are essential components to achieving improved mental health in children. Payers’ ability to develop, implement, and monitor targeted interventions at scale that address both the medical and mental health needs of individuals uniquely position them to make great impact on the trajectory of mental health of children as they age.

Children with a mental disorder contribute an estimated $247 billion yearly spend for treatment. The environment in which a child lives, how they are cared for, and the accessibility to daily necessities and educational and health services all contribute to their mental wellbeing. According to the CDC, among children living below 100% of the federal poverty level, more than 22% have a mental, behavioral, or developmental disorder. Supporting the mental health of children should include monitoring developmental milestones, supporting parents and caregivers, improving access to care, and addressing environmental factors. Across multiple states, Centene health plans have implemented community-integrated social services technology platforms to connect members with community benefit organizations to help solve for life challenges that contribute to mental health stressors. The platforms enable real-time information sharing and centralized access to community support systems, helping members access resources to improve overall health and quality of life. This holistic approach allows for intervention outside of a clinical setting while still creating lasting impact through improved daily living for children. 

Children in low-income communities are at greater risk of experiencing adverse childhood experiences (ACEs). Strong correlations exist between various ACEs and depressive symptoms, antisocial behavior, and substance misuse, which can follow children through their entire lives. ACEs can be detrimental to development by influencing how children learn, respond to stress, and make decisions. The link between ACEs and childhood trauma greatly impacts the risk of suicide. Emergency department utilization from suicidal behavior for those aged 12 to 17 increased 22% in 2020, and 39% in 2021 compared to 2019 according to data from the CDC. Targeted prevention programs that take into account cultural and environmental factors can aid in supporting this increased risk among adolescents. At Centene, our Choose Tomorrow™ suicide prevention program uses predictive modeling to identify suicide risk through data analytics prompting screening and assessment. Comprehensively trained staff use evidence-based practices to develop member-driven safety planning and monitor members’ treatment progress to prevent suicide. Care teams deliver risk prevention with compassion and respect and ensure connections are made more easily to community resources to assist members in maintaining progress toward recovery. 

Routine screenings that assess behavioral health symptoms, suicide risk, sleep problems, interpersonal violence, and social needs can aid in early identification driving appropriate and timely intervention. Many behavioral health conditions can present with physical symptoms. Because children are more likely to see a primary care provider or pediatrician, these care providers are increasingly called upon to provide guidance for not only physical health concerns, but mental health as well. To help providers gain skills in recognizing common behavioral health symptoms, Centene maintains a comprehensive library of online screening trainings covering topics such as depression, suicide risks, and substance use. These trainings are made available as part of Centene’s commitment to early identification and coordination of care between physical and mental health providers. 

Early intervention, inclusive education, and equitable access to mental healthcare is essential to safeguard the mental health of children and future generations. Payers can play a critical role in advancing mental healthcare delivery through continued support of innovative technology, evidence-based clinical programs, educational programming, and community partnerships.