This week on HealthConnection, Dr. Carole Myers, a professor emeritus in the University of Tennessee College of Nursing, talks with Mandy Spears, the deputy director of Sycamore Institute, an independent and nonpartisan research center based in Tennessee, about the mental health crisis affecting children and youth in Tennessee.
WUOT’s Carole Myers: Rates of anxiety, depression and other symptoms of poor mental health among children and youth are increasing nationwide. Rates for Tennessee children and youth are just above the current national averages. Let's examine trends in children's and youth mental health in Tennessee and the United State.
Mandy Spears: Children and youth in Tennessee and across the country are struggling with historically high levels of anxiety, depression and other symptoms of mental health. I think we've all been reading about that in the news. For example, almost twice as many youth in Tennessee died by suicide in the last decade than in the decade prior to that.
How are we as a state responding to the mental health problems of children and youth? I know you've been studying this for quite a while.
The good news is that Tennessee is doing quite a lot to respond to this. In recent years, Tennessee's made some significant investments in mental health services and programs for children. For example, we have created a new dedicated funding source called the K through 12 Mental Health Trust Fund, so that every year we have dedicated dollars to give to school-based health services. We've launched some new liaisons that work with schools to help kids with behavioral health. So there's a lot of really great and new and innovative and evidence-based things that Tennessee has adopted in recent years.
We can always do better. That's kind of a personal and professional philosophy of mine. How can we do better in addressing the mental health needs of children and youth in Tennessee? I understand that you've come up with some recommended policy actions.
Although Tennessee has done a lot, there's always more that can be done. Tennessee can explore some additional, incremental steps that we found in our research that might help the state achieve more meaningful progress for the things that we all want. They're spread across nine agencies, dozens of programs and partners in multiple sectors, and unfortunately, there's not a clear coordination or strategy behind all of these efforts. One idea is that the state could create a comprehensive strategy that brings together all these relevant agencies, all the relevant programs, and the partners that are working in all these different sectors to better plan and communicate, coordinate, evaluate and refine all of this stuff that's going on in the state, so that we get more impact and we're also being more transparent to the public.
Coordination is at the top of your list. What else is on that list, Mandy?
So we identified eight different buckets in three broad categories. Examples of some of the other things that we identified were collecting better and more timely data to understand what's really going on in real time, so that we can better respond to the problems that youth are facing. We could expand what are known as two generation approaches. These types of policies and programs try to address the child and the family needs at the same time because we know that unmet family needs have a very real impact on a child's mental health. Tennessee could continually refine our approaches as we learn what works and what doesn't in this area. So there's new research, new policies coming out all the time across the country about what might work and what might help youth mental health. We could also take a fine tooth comb to how we cover and pay for mental health care in TennCare, which is the state's Medicaid program, and private health insurance plans and the professionals and services that are available to kids in schools these types of policies, how much we pay providers, what we cover, who's covered where, all those things are shaping the affordability, the accessibility and the availability of services that kids need. So in other words, if and where services are available, and how much they cost a family. So there's a lot of different options that are available to policymakers and program administrators here in Tennessee.
I'm intrigued by the two generational approach. Is there an exemplary program where some results that you could help us to illustrate that idea even better than you have?
Yes. So there's a program called home visiting and it's available to some families, sort of in that first year of life after a child has been born. And what happens is often a nurse will visit a family in their home so that they can make sure that the kid is getting all its developmental checkups and meeting all of those milestones that we all care about, and while they're in the home, they can also see what kinds of needs that the mother of the child might have. Maybe she's struggling to breastfeed and she needs lactation support, or maybe she's struggling in those early months, like a lot of us do with postpartum depression, and she needs to get some treatment. It's really somebody coming into the home and meeting the family's full needs. There's over a decade of evidence based research behind the effectiveness of programs like that. We're already doing that in Tennessee, but it's not universally available to everyone across the state. So that is just one example of one of these sort of two generation, meet-the-needs-of-the-whole-family approaches.
Thank you. That description was helpful. I realize that these recommendations have only been recently released. What's your sense right now about how they are being received and considered by policymakers in Tennessee?
We are having a lot of really great conversations with people, both in and outside the government, that care about this and that have taken notice of this report. So I think we all hear about children's mental health, and we want to see our kids thrive and be happy and bring that into adulthood. So we are hearing a lot of good interests, both from policymakers in the legislature, those working within the agencies, to understand kind of the research that we did and where we came up with this.
This transcript has been lightly edited for content.
