The Kids Are Not All Right: Senate Hearing Highlights Children’s Mental Health Coverage Gaps

During a wide-ranging hearing on the status of America’s mental health system before a Senate health committee on Thursday, Sen. Al Franken (D-MN) declared his intention to introduce the Mental Health In Schools Act to address issues of mental illnesses among America’s youth. Thursday’s event was the first Senate hearing on mental health care in six years, as the U.S. is currently engaged in a renewed national conversation on gun safety and mental health issues after last month’s tragic shooting at Sandy Hook Elementary School.

Franken explained that his legislation would “allow schools to collaborate with mental health providers, law enforcement, and other community-based organizations to provide expanded access to mental health care for their students” and “support schools in training staff and volunteers to spot warning signs in kids and to refer them to the appropriate services.”

While emphasizing that he didn’t want to inaccurately stigmatize most Americans with mental illnesses as being predisposed to violence, the senator questioned the director of the National Institute of Mental Health, Dr. Thomas Insel, about the correlation between untreated mental problems in American youth and subsequent violent behavior:

FRANKEN: If mental health issues go untreated, does that increase the chance that someone within a subset, a certain subset of a type of mental illness, will become more violent, Dr. Insel, or will be higher chance that they might become violent?

INSEL: So, Sen. Franken, within that narrow band of the people we’re talking about — which is a small, small segment of the population of people with a mental illness — but those, for instance, who have what we call ‘first episode psychosis’ — we know that the duration of untreated psychosis is related, in fact, to the risk for having a violent act. That’s been studied quite carefully and there’s a real correlation there, so closing that gap is one of the things we can do to increase safety.

FRANKEN: So since, in a sense since Newtown did prompt this, in that very narrow — and that was one of a number of horrific occurrences where I think that no one would question that in Tucson, in Newtown, that we’re talking about someone who’s deranged — that had that person been diagnosed, say, in school and had been able to get some kind of treatment, that there is some kind of connection between making sure that we’re identifying and treating children early on with the tragedy that brought us here?

INSEL: …The published data are quite clear. The difference between severely violent acts like homicide between those who are untreated and those who are treated is fifteen fold. So you drop the risk fifteen fold with treatment. So it’s vital — it’s absolutely vital — that we detect earlier and intervene earlier with something that’s effective.

While the public education system serves as American children’s primary resource for accessing mental health care, only one in five American children in need of treatment actually receives it. This is particularly problematic considering that half of all lifetime mental disorder cases set in by the age of 14.

But if the last several weeks are any indication, lawmakers seem to have woken up to the fact that the current trend is unsustainable. Franken’s proposal for expanding the public school system’s mental health safety net would work in conjunction with President Obama’s Project AWARE initiative to provide similar support and training to schools and other community-based organizations.