Health Care

Child use of mental health services doubles in two decades, report finds

Morgan Crossman, executive director of Building Bright Futures, speaks at a press conference at the Statehouse in Montpelier on Wednesday, January 8, 2020, during which the organization released its seventh annual report on the well-being of Vermont’s children. Photo by Glenn Russell/VTDigger

The number of children accessing mental health services in Vermont has doubled over the past two decades, according to a new report from a group that measures early childhood outcomes in the state.

A report from Building Bright Futures found that in 2018, 3,322 children 9 and under utilized mental health services in Vermont — up from 1,708 in 1999. That comes despite a steady decline in the total number of children in the state over the same period.

Department of Mental Health Commissioner Sarah Squirrell said at a press conference Wednesday that the reasons driving the increase are “complex and interlocking.”

One factor that she said that has clearly contributed to the rise is the ongoing opioid addiction epidemic, and the impact it has on the state’s children.

Squirrell said five or six years ago, the number of babies born with opioid dependencies hit a peak. Now, she said, those same children are entering elementary school for the first time, and in some cases, getting screened for mental health challenges for the first time.

According to the new report, one in three Vermont children experience at least one “adverse childhood experience” before age 9 — a major indicator of children that might experience negative outcomes later in life.

The most common adverse childhood experiences in Vermont are living in a home that struggles to cover basic needs, experiencing the divorce of a parent, living with someone with a substance use disorder, and living with someone with a major mental health challenge.

Squirrell said in order to combat the mental health challenges that come with those experiences, the state needs to ensure that from a young age, children are being screened and treated for their mental, emotional and behavioral health challenges.

“The bottom line is, the earlier we intervene, the better the outcomes,” Squirrel said.

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The bright side, she said, is that Vermont is good at identifying children in need of support. In 2017, 61% of Vermont children received a developmental screening, which Squirrell said is one of the largest factors in ensuring that the children who need support are able to get it.

“Parents should not be afraid to talk to their providers about the social/emotional development of their children,” Squirrell said. “There’s no wrong question to understand what the developmental milestones that they should be looking for.”

Morgan Crossman, the executive director of Building Bright Futures, said the recommendations are based on information gathered by the organization from regional offices and statewide employees.

Cheryle Wilcox, interagency planning director with the Department of Mental Health, said one key recommendation is building support for parents and caregivers to care for their own wellbeing as well as that of their children.

“One thing that comes to mind is when you’re on a plane and someone says if you’re a parent, put on your oxygen mask before you put on your child’s,” she said. “If you’re not well and you’re not supported, it’s hard to do that.”

Building Bright Futures also advocated for making the mental health care system easier for caregivers to navigate. The percentage of children getting developmental screenings varied from 78% in Middlebury to only 34% in Newport, according to the report.

One parent shared her experience with raising three children adopted from foster care. Karoline May said she struggled to get daycare workers to recognize and accommodate her oldest son’s physical delays.

“When he couldn’t sit or reach the water table — which he absolutely loved — they just removed him from the group,” she said.

She later enrolled her children in a daycare partnered with Washington County Mental Health Services that helped with their needs and led her to even more treatment. “There are a lot of people in our situation who wouldn’t know how to handle it,” she said.

The report also highlighted the continued need for affordable childcare and for more childcare workers. Vermont expanded family eligibility for childcare subsidies in 2019, making it easier for parents just above the poverty level to receive subsidies for childcare.

Rep. Ann Pugh, D-South Burlington, said she was proud of the new subsidies. 

“Those conditions allow parents to work or go to school, and it allows employers to have employees who are focused on the job and not worry about, ‘where are my children?’” Pugh said. “I am here to share with you the commitment the Legislature has for building bright futures for our children.”

Pugh, who is a social worker, UVM professor and long-time chair of House Human Services, said she has learned that “change happens when you pay attention to it, and you have the data.”

“One of the incredible values of Building Bright Futures is that it presents to us data that will move us forward and direct the changes that we have to make,” she said.

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Jay Eshelman

It stands to reason that child use of mental health services has doubled. Vermont’s K-12 education monopoly has the largest percentage of students labeled with behavioral disabilities per capita in the U.S.. And, arguably, the education establishment labels those students to increase spending on the social services these special interest groups provide. Either that or there’s something in the water we drink. Perhaps it’s the Kool-Aid.

Robert Kenney

The number or children medicated has also doubled, or tripled, or quadrupled since 1999. Is there a correlation?

Paul Slobodian

There is a great push to label kids and adults with a diagnosis…and the more the better. Lots of dollars flow to the government entities and non profits. Don’t get me wrong…most workers are well -intentioned….and their wide screening net helps some people. But: being labeled (and sometimes medicated) has risks and harms too. Did you see the news Google has access to millions of health records with full identifying inormation? If you have a child in school please be very sceptical when they tell you to enroll your child in a special program.

Carol Auerbach

Mental health is a business. Why must so-called educated professionals do what laws and policing should have been doing since day one? The ancient notion that Vermont be independent from the continent has resulted in a cunning beauracracy that will commodify mental illness FOR PERSONAL GAIN!

Catherine Antley, MD

“The most common adverse childhood experiences (ACEs) in Vermont ..[include] living with someone with a substance use disorder..” Child advocates and others aim to decrease ACEs. Commercialization of marijuana will increase use and use disorder. The meager taxes will not cover resulting increased addiction or children suffering as a result . “For profit companies can be expected to focus on creating and maintaining ..heavy users. Dependence Is good the bottom line…our free speech doctrine ..makes it very hard to restrict advertising and marketing.”-Dr. Beau Kilmer ofVT Rand report

Robert Burton MD

Wow! Great awareness through the commentaries below! It was more than 50 yrs ago that I completed my military obligation and started as a UVM College of Medicine project with reasonable success. Extra time at VSH, Waterbury plus a lifetime career in the ER trenches left an indelible impression of the challenges of this population and the botched result when government manages it. If I’d forgotten, it was reinforced recently by an awareness of DCF “trafficking in children” as it bolsters it’s clientele pool using its predatory instincts on the unfortunate and unwary. The legislature chooses to reinforce this monopoly by adding to the addiction pool through ill advised legislative boondoggle. As always, the private sector operates superbly by comparison. If you’re wondering why health care is declining, look no farther than bureaucratic regulation, interference, and self serving. The solution: Get the Fox out of the Hen House. (No comment on the proverbial “Squirrell/nut” relationship).


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