ASI Session Summary: Addressing Our Children's Mental Health Needs

NCSL Assembly on State Issues - Children, Families and Health Committee - Joint ASI/AFI Meeting, December 2001

Addressing Our Children's Mental Health Needs

Presiding: Representative Dave Heaton, Legislative Chair, ASI Children, Families and Health Committee
Leon Czikowsky, Staff Chair, ASI Children, Families and Health Committee

Calming the Chaos: Responding to the Mental Health Needs of Children

Moderator: Elaine Zimmerman, Executive Director, Connecticut Commission on Children, Staff Vice Chair, ASI Children, Families and Health Committee

Speakers: Albert Zachik, M.D. Director, Office of Child and Adolescent Services, Department of Health and Mental Hygiene, Maryland
James Mayer, Executive Director, Little Hoover Commission, California

Elaine Zimmerman opened the session with an overview of the impact of the September 11^th terrorist attacks on the lives of children. More than 10, 000 children lost parents in the attacks in New York City, Virginia and Pennsylvania. Children were affected regardless of whether their parents were physically involved in the tragedies. The Connecticut Commission on Children collected children's artwork created in response to the terrorist attacks, and presented the compilation in a video, "I Will Never Trust the Sky Again."

Dr. Albert Zachik summarized the report of the Surgeon General's Conference on Children's Mental Health, published in September 2000. In the U.S., one in 10 children and adolescents suffer from mental illness severe enough to cause some level of impairment. He emphasized that mental health is a critical component of children's learning and general health. According to Dr. Zachik, a children's mental health system should include prevention, early identification, assessment and treatment. He also noted that children's mental health services should be integrated into various systems-child care settings, schools, social services and juvenile justice systems. Dr. Zachik discussed available mental health services as well as gaps in such services, such as a lack of qualified, child-trained mental health providers; funding for services and coverage for services in private insurance plans. He recommended that policymakers consult guidelines and resources published by the American Academy of Child and Adolescent Psychiatry.

Jim Mayer discussed a September 2001 report by the Little Hoover Commission, Young Hearts and Minds: Making a Commitment to Children's Mental Health. One million children in California will experience emotional or behavioral disorders and 150,000 children are served by California's public mental health system. Due to a lack of standards, children do not generally receive appropriate and timely care. Outcomes are unmeasured, which results in little pressure to improve existing mental health systems. In order to create a system that is responsive to children and families, the report recommends that mental health services be integrated into all social service systems, and encourages private and public sector collaborations to ensure access to care. The report also recommends that funds and services be invested in prevention and early intervention. The Commission outlines five findings to improve mental health services for children: ensure appropriate care, provide appropriate resources, invest in leadership, ensure sufficient personnel and serve children and families.

Identifying and Intervening with Troubled Kids

Moderator: Elaine Zimmerman, Executive Director, Connecticut Commission on Children, Staff Vice-Chair, ASI Children, Families and Health Committee

Speakers: David Osher, Ph.D., Director, Center for Effective Collaboration and Practice, American Institutes for Research, Chesapeake Institute, Washington, D.C.
Robert Murphy, Ph.D., Research Coordinator, National Center for Children Exposed to Violence, Connecticut

Dr. David Osher provided an overview of the impact of exposure to violence and trauma on children including depression, anxiety, anger, behavioral problems and substance abuse. He supports a comprehensive, three-tired approach including coordination within schools, commitment to all students and cultural competence. Dr. Osher listed approaches that he has found to be ineffective including segregating anti-social youth, punishment without positive behavioral support, lectures, boot camps, group counseling and fragmented services. He presented approaches that have been successful, including addressing multiple risk factors, consistent intervention, culturally/linguistically competent intervention and efforts to screen and refer youth to appropriate services. Dr. Osher also discussed anti-bullying techniques and counseling as interventions.

Dr. Robert Murphy provided statistics on violent crime as well as school crime and its impact on teachers. He listed the effects of violence and trauma on children, such as anger, nightmares, repetitive play, withdrawal, sadness, flashbacks and attention problems. He discussed how adults can talk about terrorism with children, and addressed the importance of discussing death with children-specifically helping them to realistically understand death and reduce confusion and distress. He outlined the principles of community response, including student and family involvement, collaboration, shared responsibility, crisis response planning, professional development and training and evaluation. Dr. Murphy supports two effective strategies: the child development community policing program and the school crisis prevention and response program. He encourages investigating various program models and service modalities, determining access to treatment, integrating systems of care, collaborating and sharing information, investing in community, and blending funding streams.

NCSL staff contact: Leah Oliver at 303-364-7700