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AAP, AACAP, CHA declare national emergency in children’s mental health

The AAP, American Academy of Child and Adolescent Psychiatry (AACAP), and Children’s Hospital Association have declared a national emergency in children’s mental health, citing the serious toll of the COVID-19 pandemic on top of existing challenges.

They are urging policymakers to take action swiftly to address the crisis.

“Young people have endured so much throughout this pandemic and while much of the attention is often placed on its physical health consequences, we cannot overlook the escalating mental health crisis facing our patients,” AAP President Lee Savio Beers, M.D., FAAP, said in a statement. “Today’s declaration is an urgent call to policymakers at all levels of government — we must treat this mental health crisis like the emergency it is.”

Before the pandemic, rates of childhood mental health concerns and suicide had been rising steadily for at least a decade. By 2018, suicide was the second leading cause of death for youths ages 10-24 years.

The pandemic then brought on physical isolation, ongoing uncertainty, fear, and grief. Centers for Disease Control and Prevention researchers quantified that toll in several reports. They found between March and October 2020, emergency department visits for mental health emergencies rose by 24% for children ages 5-11 years and 31% for children ages 12-17 years. In addition, emergency department visits for suspected suicide attempts increased nearly 51% among girls ages 12-17 years in early 2021 compared to the same period in 2019.

Additionally, many young people have been impacted by the loss of a loved one. Recent data show that more than 140,000 U.S. children have experienced the death of a primary or secondary caregiver during the COVID-19 pandemic, with children of color disproportionately impacted.

“We are caring for young people with soaring rates of depression, anxiety, trauma, loneliness, and suicidality that will have lasting impacts on them, their families, their communities, and all of our futures,” said AACAP President Gabrielle A. Carlson, M.D. “We cannot sit idly by. This is a national emergency, and the time for swift and deliberate action is now.”

In the declaration, the groups emphasize that young people in communities of color have been impacted by the pandemic more than others and how the ongoing struggle for racial justice is inextricably tied to the worsening mental health crisis.

“Children and families across our country have experienced enormous adversity and disruption,” the groups stated in the declaration. “The inequities that result from structural racism have contributed to disproportionate impacts on children from communities of color.”

The organizations are urging policymakers to take several actions:

  • Increase federal funding to ensure all families can access mental health services.
  • Improve access to telemedicine.
  • Support effective models of school-based mental health care.
  • Accelerate integration of mental health care in primary care pediatrics.
  • Strengthen efforts to reduce the risk of suicide in children and adolescents.
  • Address ongoing challenges of the acute care needs of children and adolescents.
  • Fully fund community-based systems of care that connect families to evidence-based interventions.
  • Promote and pay for trauma-informed care services.
  • Address workforce challenges and shortages so that children can access mental health services no matter where they live.
  • Advance policies that ensure compliance with mental health parity laws.

“We must identify strategies to meet these challenges through innovation and action,” the groups wrote, “using state, local, and national approaches to improve the access to and quality of care across the continuum of mental health promotion, prevention, and treatment.”

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