The Children’s Mental Health Crisis

Released: March 10th, 2022

The Children's Mental Health Crisis

The pandemic has had a devastating impact on children’s mental health due to factors such as increased isolation, anxiety, and learning loss. The Biden Administration recently highlighted this crisis and announced a national mental health strategy in the State of the Union. Among other plans, President Biden shared actions to address social media’s negative impact on mental health, including increasing online protections and stopping discriminatory algorithmic decision-making. Also highlighting this concern is the probe into TikTok’s impact on children and teens’ health and the bill introduced to limit social media’s harmful effects.

• Support in Schools: There are calls to increase mental health services in schools and a new report rates how well states are doing in terms of programming and support. The report was published by a group of 17 national mental health organizations and shares ways to support comprehensive mental health services in schools.
• Eating Disorders: Recent data from the Centers for Disease Control and Prevention (CDC) indicates that emergency room visits for eating disorders doubled among teenage girls during the pandemic. It is important to support LGBTQ young people, who experience significantly higher rates of eating disorders compared to their cisgender and heterosexual peers.
• LGBTQ: The debate around transgender youth accessing care raises mental health concerns for this vulnerable population, who are already at high risk of suicide. Additionally, there are concerns that not being able to teach about sexual orientation and gender identity could be harmful to students’ mental health. LGBTQ youth who experience homelessness or housing instability report greater rates of mental health challenges, including depression, self-harm, and suicide attempts.

Resources & Initiatives

• The Child Mind Institute shares resources on different kinds of eating disorders, signs to watch for, and family-based treatment.
• BlueCross BlueShield of South Carolina shares videos with information on how bullying impacts mental health and cyberbullying.
• See NIHCM’s recent infographic on the pandemic’s impact on children and our webinar on investing in children’s health and well-being.

COVID Updates: Masking, Long COVID, and Vaccines

Recent estimates from the CDC indicate that over 43% of the country has been infected by COVID-19, with about 58% of children having been infected. As COVID cases continue to decline, the White House unveiled a new plan to get things back to normal. The plan includes a goal to offer testing and access to antiviral pills at hundreds of pharmacies, community health centers, and other sites.

• Masks: The CDC outlined new guidance for communities based on COVID-19 at the community level, leading many people to take a break from wearing masks. Many states are ending their mask mandates or letting them expire. Schools are allowing children to come without masks, prompting concerns about the low childhood vaccination rates. Learn more about when you should wear a mask.
• Long COVID: Researchers continue working to understand long COVID and guide treatment, which includes recent evidence on brain damage. NIHCM grantee, The Journalist’s Resource, shares an explainer that answers key questions about long COVID, such as its symptoms and how it is diagnosed. Legislation has been introduced to address the need for more research on long COVID.
• Vaccines: About 65% of Americans are fully vaccinated against COVID-19. The U.S. is about to approve a fourth vaccine by Novax, which could potentially increase that number. Additionally, CDC data underscores that vaccines provide protection against severe illness and hospitalization among children. However, parents are still waiting for the approval of a vaccine for children under five. Also, learn more about when you might need a second booster dose.

Resources & Initiatives

• Tune into NIHCM grantee, the Center for Health Journalism’s upcoming webinar on unequal access to COVID treatments, featuring Aaron Carroll, MD.
• Every home in the U.S. is now eligible for four free at-home COVID-19 tests and here is how to order yours. Learn more from Wellmark about different settings to get tested.
• Horizon Blue Cross Blue Shield of New Jersey shares information on which masks best protect you against COVID-19.
• Blue Cross Blue Shield of North Carolina shares information on the first COVID-19 treatments to come in pill form.
• Learn more about the pandemic’s impact on children from a recent NIHCM infographic.

Rural Health: COVID-19 and Barriers to Care

The rural population often faces significant barriers to accessing health care, many of which COVID-19 has exacerbated. Due to the pandemic being declared a “public health emergency,” a federal mandate protected Medicaid enrollees from losing coverage, loosened telehealth guidelines, and increased providers’ flexibility. Studies show that even prior to the pandemic, the rural health safety net was becoming increasingly unstable. The end of the public health emergency, staffing shortages, and expiring funding, leaves the rural health safety net especially vulnerable.

• COVID-19 Status: COVID-19 rates in rural communities have declined by more than 75% since mid-January. However, over 80% of these areas still have an infection rate of at least 100 new cases per 100,000 people. Vaccination rates are increasing with 50% of the total rural population fully vaccinated as of February 24th.
• The Rural Health Safety Net: As a result of pandemic relief programs, many rural hospitals improved their economic status, with only 40% operating in the red compared to the 46% in pre-pandemic years. With federal funding aid packages soon expiring, more rural hospitals may soon face closure.
• Efforts to Improve Rural Health: In 2021, 61% of health care shortage areas were located in rural communities with roughly 4,000 additional primary care practitioners needed to meet current community needs. The Biden Administration is taking steps to improve rural health through lowering costs, expanding coverage, increasing access to telehealth, and bolstering the rural health care provider workforce.

NIHCM recently released an infographic on the current state of rural health in the U.S., including the impact of COVID-19, access to care, and interventions to improve rural health.

Resources & Initiatives

• NIHCM held a webinar on rural health with leaders in the field, who discussed federal health policy efforts, the pandemic’s impact on health care services, and equitable vaccine access.
• Blue Cross and Blue Shield of Minnesota teamed up with a local hospital to improve access to obstetrics across the state by optimizing labor and delivery care for patients.
• The Trevor Project published a report on LGBTQ youth in small towns and rural areas, examining depression and suicide risk among LGBTQ youth from rural communities compared to urban and suburban areas.
• Wellmark Blue Cross and Blue Shield of Iowa released their 2022 Healthy Hometown finalists through the Wellmark Community Award, which recognizes awardees for their community-based health improvement initiatives.
• NIHCM grantee, Vox, published a report on maternity wards in the U.S., which despite rising maternal mortality rates, are closing across the country; these closures create a gap in services that are accessible to the community, especially among rural areas.

The Pandemic’s Impact on Older Adults

The pandemic has disproportionately impacted older adults. While individuals over the age of 65 account for 16% of the U.S. population, the CDC reports that this age group accounts for 75% of deaths from COVID-19. During his State of the Union, President Biden announced plans to significantly improve nursing home quality, including addressing staffing shortages.

• Well-Being: A new report funded by the CDC Foundation examined the needs and concerns of older adults and found that, during COVID-19, older adults reported feeling socially isolated and lonely. Health experts are also pointing to how the pandemic upended daily routines for older adults and how that has impacted physical activities and mobility.
• Alzheimer’s: A new study found that deaths among people with Alzheimer's disease and related dementias surged 26% during the first year of the pandemic, especially among beneficiaries living in nursing homes.
• Long-Term Care: Residents in long-term care facilities were hit hard by the pandemic, and the industry continues to struggle with staffing shortages, high turnover, and burnout.

Resources & Initiatives

• Blue Cross and Blue Shield of North Carolina shares a family’s story of illness and caregiving.
• The Equitable Healthy Aging in Public Health Toolkit Report
• The CDC published tailored information on COVID-19 risks and vaccine information for older adults.
• CNN reports on a new study that shows pets can boost brain power and may delay memory loss and other kinds of cognitive decline.