Methuen Education Official Calls Schools the ‘Prevention Arm of the Mental Health System’

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A report that tapped a Methuen school official, among others, suggests the potential for schools and pediatric primary care providers to play a more significant role in addressing a “long-standing crisis” in children’s behavioral health,

The 45-page report, released Thursday by the Massachusetts Association of Health Plans, draws from 25 interviews with unnamed system insiders to lay out insights and recommendations for policymakers to weigh this year as the state begins implementation of a mental health access law that was signed in August. The mental health care law enacted over the summer calls for a statewide program to provide assistance for implementing behavioral health services in each school district, and requires each school committee to ensure that all schools have written medical and behavioral health emergency response plans. It also charged the state Health Policy Commission with preparing a behavioral health planning report every three years.

“It will be essential to consider schools as the prevention arm of the mental health system writ large and the importance of leveraging schools to foster proactive, preventative identification of students with emerging mental health concerns and the delivery of evidence-based mental health services and supports for students,” said John Crocker, director of mental health and behavioral services for the Methuen Public Schools.

Doing so, he said, “will require investment in capacity building for schools, both systematically to design comprehensive school mental health systems to organize and deploy services effectively and supporting school-based mental health staff’s professional development to deliver evidence-based therapeutic care to students.”

The report calls on Gov. Maura Healey’s administration to continue with a roadmap developed under Gov. Charlie Baker’s administration that aims to create a “front door” to the behavioral health care system. That roadmap is designed to make a 24/7 behavioral health help line available this year, ensure coverage for preventive behavioral health services in primary care settings, grow community behavioral health centers, increase inpatient and 24-hour behavioral health beds and deliver rate increases for behavioral health providers.

The report also recommends changes to bring more order and cohesion to a system knocked by critics as too disconnected and lacking coordination. It recommends the creation of a public education campaign regarding the availability of urgent care and crisis services, the development of specialty services for high-need children, and more coordinated care for children who receive services from multiple agencies.

“Stakeholders universally supported these policies and believed that they formed a solid foundation for addressing the identified challenges,” according to the report.

Citing numerous sets of statistics, the report chronicles the “alarming” numbers of young people struggling with behavioral health challenges, stating that even before the pandemic, those challenges “were the leading cause of disability and poor life outcomes in young people.”

“COVID-19 made a bad situation even worse,” the report says.

A U.S. Surgeon General report in late 2021 said that since the start of the pandemic, 25% of youth who were surveyed experienced depressive symptoms and 20 percent reported feeling anxious—”in both cases, more than double the pre-pandemic rate.”

The report says Massachusetts is lower than the national average for teen suicide and traumatic events known as “adverse childhood experiences,” but higher than the national average for anxiety, depression, alcohol use and illicit drug use among children and adolescents. In Massachusetts, nearly 64% of children with severe depression do not receive any behavioral health treatment, compared to nearly 60% nationally.

Michael P. Norton

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