Screen children for mental health

May 26, 2010

Children and adolescents are not having their eyes and ears screened ("Millions of Medicaid kids don't get medical exams," May 24), but they are also not having one of the body's most important organs checked — their brains.

Adolescents are often in their healthiest years, but mental and emotional difficulties can cause problems at school and at home. More serious illness, if undetected, can lead to long-term disability and even suicide. Indeed, 50 percent of all lifetime mental health disorders start by age 14, according to the National Institute of Mental Health.

An evidence-based mental health checkup can detect mental health problems early and link teens to services they need. The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit of Medicaid requires that a developmental or mental health assessment be offered at the annual well-child visit. However, many providers, as noted in The Sun article, are not regularly providing this essential service.

Health care reform also requires that all new health plans offer depression screening as a free preventive service to enrolled beneficiaries beginning at age 12.

In spite of federal laws that support mental health checkups, many young people are never screened for mental illness. Systems of care must be improved to make it easier for providers to include screenings in their practice.

As mentioned in the Health and Human Services inspector general's report on Medicaid examinations, requiring reporting of the mandatory preventive screening components of EPSDT to the Centers for Medicare and Medicaid Services will help to monitor whether they are being done.

Reimbursing pediatricians, family practitioners and other providers for time spent reviewing and discussing a mental health screen would also assist them in taking time to offer screenings to their patients.

Mental health checkups should be part of a complete annual well-child visit that includes routine vision and hearing tests. Reducing the barriers to routine preventive screening is an on-going challenge. Encouragingly, the stage for change is set like never before with EPSDT, health reform and mental health parity legislation. There is no time like the present to make the mental health of our youth a national priority. Doing so can save lives.

Laurie Flynn, New York

The writer is executive director of TeenScreen National Center for Mental Health Checkups at Columbia University.

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