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Oregon mental health professionals are frustrated with youth.
At a roundtable discussion Thursday, health care providers and representatives from the Tribal Health Agency and Portland Public Schools expressed frustration that public and private health insurance plans are taking so many young people without treatment.
They called for an expansion of the mental health care workforce in schools and the renewal of outdated regulations limiting care locations and providers. He also said the federal government should hold insurers accountable for denying children behavioral health care coverage.
The roundtable was convened by Oregon US Senator Ron Wyden at Oregon Health & Science University’s Southwest Portland campus. Chiquita Brooks-Lasure, director of the federal Centers for Medicare and Medicaid Services, as well as parents and students, joined to discuss youth mental health issues in the new school year.
Wyden said children in Oregon “have been sounding the alarm loud and clear” that more mental health support is needed.
Other participants agreed.
A 2020 survey of nearly one-third of Oregon students conducted by the Oregon Health Authority and the Oregon Department of Education found that nearly half felt sad or hopeless for more than two weeks. And a report released this week by Annie E. Casey FoundationThe number of Oregon children struggling with mental health issues rose from 11 percent in 2016 to 16 percent in 2020, a 40 percent increase.
Wyden said the outbreak has exacerbated the mental health crisis among Oregon children. “This is a pre-pandemic issue, and it’s mushrooming,” he said.
Wyden, Brooks-LaSure and health care providers agree that schools need more counselors and therapists. He said Medicaid is needed to make mental health care more accessible.
In Oregon, about two out of five children are on Medicaid, the federal program that covers low-income families. Nationally, about half of children get free coverage from Medicaid and the Children’s Health Insurance Program, or CHIP.
Expansion of human resources
In the year In 2019, the state allocated more than $1 billion to the Student Success Act of 2019, which helped pay for mental health care in schools. In addition, Oregon received millions from the America’s Rescue Plan during the outbreak, directing some of it to be used by mental health workers and programs.
Oregon Department of Education Director Colt Gill said the money didn’t solve the problems.
“The Student Success Act gave us money for more counselors,” Gill said at an Oregon Senate Education Committee meeting in November. “We can’t find them.”
One mother said during the interview that her son had been on a waiting list for a school counselor for six months.
Brooks-Lasure said her agency is accepting public comment on a policy to increase the number of mental health care providers in schools, giving counselors more flexibility in who they treat and their focus. For example, they may treat school children and veterans, or they may work in schools but also provide family counseling. This brings professionals who are not currently working in schools. The people can. Enter comments Until the end of August.
Rep. Lisa Reynolds, D-Portland, and a pediatrician, said about 30% of her patients are on Medicaid. Some wait weeks or months to see a therapist because of a shortage of mental health professionals.
Reynolds said more doctors should be trained in mental health care, and pay for social workers, counselors and therapists should increase. Although Oregon regulations require equal pay for physical and mental health care, therapists are typically paid less than those who provide physical care. Increasing fees will increase the number of professionals, she said. “We need to compensate mental health care providers like physical health care providers,” she said.
Randy Kamphaus, director of the University of Oregon’s Institute for Child Behavioral Health in Portland, which offers a curriculum for students interested in the field, said interns should be paid during their training. The institute’s first class of 200 elementary students will be in Portland Public Schools by the fall of 2023, Kamphaus said. They begin by screening students to identify those who are at risk or vulnerable to mental health problems.
Outdated regulations inhibit progress
Many of the medical providers on the panel expressed frustration with policies that limit care under Medicaid.
Laura Platero, executive director of the Northwest Portland Area Indian Health Board, said the restriction, which allows providers to charge only when care is provided at the facility, remains particularly restrictive. She told Brooks-LaSure that Medicaid should be expanded for tribal activities, such as the canoe program that provides healing for Native American youth. The curriculum incorporates tribal traditions and practices to strengthen children’s connection to their culture and combat suicide and drug abuse.
Her agency has struggled to help children with their mental health, she said.
“We have a very hard time getting treatment for young patients, and when we do, we have to wait or it’s very expensive,” she said.
Robin Henderson, CEO of Providence Behavioral Health, said she oversees the only child psychiatry unit in the state and often has a waiting list. Administrators face the biggest problem with payments from private insurers, she said. All insurers in Oregon are required to include the clinic in their network, but many are not, she said.
“We need regulators to hold insurers accountable,” she said.
She criticized requirements by some insurers for prior authorizations before allowing treatment. Many often deny coverage, she said.
“I can’t tell you how many times I’ve heard back, ‘Well, this is a behavioral health problem,'” Henderson said. She called on Wyden to push insurance reforms in Congress.
Allowance for school counselors
Wyden said the students’ “passionate call for help” pushed the latest Safer Communities Act over the finish line. The act, which would include $1 billion over five years for school counselors, was included in the gun safety legislation passed by Congress in June.
Oregon student Trace Terrell Wyden, a senior at La Pine High School, testified before the US Senate Finance Committee. Terrell says that 80% of his peers who come for counseling have never heard from a counselor.
Wyden said Thursday that Terrell’s testimony had a significant impact on the committee, which played a major role in writing the gun safety legislation.
Wyden said more help is on the way. States suggested Congress could pass a “major bipartisan package” to increase youth mental health professionals.
Oregon Capital Chronicle It is part of State News Division, a network of grant-supported news bureaus and a coalition of donors as a 501c(3) public charity. The Oregon Capital Chronicle maintains editorial independence. For questions contact editor Lynne Terry: [email protected]. Follow the Oregon Capital Chronicle Facebook And Twitter.
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