COVID-19 isn’t just affecting our physical health and daily life—it’s also wrecking havoc on the mental health of our children and families. Whether it’s a lack of access to mental health treatment, loneliness and depression from isolation, fear of contracting COVID, stress and anxiety from racism, or despair from job loss—our country is in pain and our emotional well-being has been compromised.

 

Mental health experts are becoming increasingly concerned about an emerging mental health crisis that our current system isn’t prepared to handle. While Virginia has made significant strides towards creating a more equitable behavioral health system, disparities in access and quality exist. Now, more than ever, policymakers must recommit to building a comprehensive continuum of behavioral health services for our children and families.

 

On August 18, policymakers will gather once again to make tough decisions about the state budget and which funding priorities they will “reallot” or “unfreeze.” Policymakers have an opportunity to mitigate the negative impact this pandemic has on our children’s mental health by reinvesting in the following behavioral health priorities:

 

Make permanent or otherwise extend telehealth flexibilities granted during the pandemic. A bright spot during the public health crisis has been the widespread use of telehealth services across the Commonwealth. As compared to primary care services, behavioral health service utilization remained relatively stable during the pandemic due to new telehealth allowances. To ensure equitable access to telehealth services moving forward, broadband capacity issues and telehealth flexibilities must be addressed. Telehealth flexibilities should:

• Telehealth reimbursement parity
• Allow for home and school to be considered an “originating site”
• Permit phone-based care
• Increase minutes available on Medicaid phones

 

Re-allot funding that invests in behavioral health systems and supports that improve equitable access to quality services. These services include:

• Medicaid Redesign: $13.6 million. Efforts to transform our behavioral health system includes implementation of evidence-based services that have demonstrated impact and value to children and adults and provides alternatives to and step-down from psychiatric admissions. In response to feedback from stakeholders, Virginia’s Medicaid office has now added a racial equity workgroup, a critical first step to addressing racial inequities in our behavioral health system.

 

• Continue implementation of STEP-VA: $54 million. STEP-VA services improve access, increase quality, build consistency, and strengthen accountability across Virginia’s public mental health system.

 

• Virginia Mental Health Access Program (VMAP): $8.4 million. Often times, concerns about a child’s mental health are first discussed with the families’ pediatrician. VMAP supports the integration of behavioral and physical health and builds the capacity of pediatricians to identify, diagnose, and treat mental health concerns through consultation, training, and referral support. The pandemic has and will continue to have an impact on the behavioral health of children in Virginia and Pediatricians need support to effectively address this need.

 

Re-allot funding to support behavioral health workforce development and retention efforts. The behavioral health workforce shortage crisis is well documented. Our community services boards (CSBs) lack sufficient workforce capacity to address challenges in workforce recruitment and retention. CSBs often have difficulty hiring and retaining licensed clinical staff because salaries are often not competitive and reimbursement levels are low. As we build out a better mental health system, intentional efforts to support and develop an equitable workforce is paramount. These efforts include:

• Fund the Behavioral Health Loan Repayment Program: $3.4 million
• Increased Medicaid mental health provider rates to 110% of Medicare: $4.9 million
• Fund additional clinical staff at the Commonwealth Center for Children and Adolescents (CCCA): $1.5 million.
  • While admissions at CCCA dropped to 50 percent capacity during the pandemic, ongoing mental health needs will likely cause a surge in admissions to the state’s only inpatient psychiatric hospital for children in the following months. To date, CCCA has incurred $115,333 in COVID-19 related expenses that remain unmet. To maintain a safe and therapeutic environment at CCCA, additional clinical staff is needed.

For too long, the stigma of mental health needs has influenced both policy, funding and practice in Virginia, leading to unnecessary and unfair suffering. While our battle against COVID requires all our collective will, we hope lawmakers will prioritize the mental health needs of children and families as they make tough decisions about our state budget.

 

 

 

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