Mental Health Services are Vital for Children


Mental health is one of the most important aspects of a child’s overall health and wellbeing. While Florida has the third highest percentage of mentally ill uninsured people in the country, the state ranks 49 out of the 50 states in spending for the provision of mental health services. The problem goes well beyond funding. Access to mental health resources for children are limited due to the lack of school counselors, the limited information provided to children and parents about mental health resources, poor/lack of insurance coverage, and more. Expanding public awareness and education about mental health is an important first step to getting children the support they need.

Mental illness that is not diagnosed at a young age can lead to increased interactions with the juvenile justice system, especially for minority children. According to The National Alliance on Mental Illness, mental illness and substance abuse typically feed into one another. Children who do not receive treatment for mental health issues can be at risk for abusing substances, and vice-versa.

Left Untreated Mental Health Issues Can Be Deadly

Untreated mental health issues and unaddressed risk factors can tragically result in attempted or completed suicide. For children aged 10-14, suicide is the second leading cause of death. Florida’s rate of completed suicides has remained steadily above the national average since 2015. From 2013 to 2020, there has been an alarming 15% increase in suicide rates in children aged 5 to 11. Among the child who died by suicide in this time period, 80% had expressed their suicidal thoughts or thoughts of self-harming. These deaths could have been prevented.

Children and adolescents experience rapid changes in their lives that can contribute to emotional instability. Combined with incomplete brain development, children and adolescents are at particularly high risk of ideation, impulses, and attempts of suicide. Equiping parents and school personnel with knowledge about the risk of suicide for children can open preventative conversations, giving children the room to express suicidal ideation, ultimately preventing it from manifesting.

Better risk assessments, more education and awareness of mental health for youth, and a greater availability of counselors and social workers for school children all have the power to reduce the number of children who become victims of attempted and completed suicide.

Racial Disparities Impact the Treatment and Response to Mental Health Issues

Minority children that are exposed to more risk factors such as violence, social disorganization, discrimination, racism, poverty and hunger are at a higher risk for mental health problems. Even with this identified, Latinx children in Florida are less likely to receive treatment for mental, emotional, developmental, or behavioral issues than their white peers (37.5% to 44%). A study of visits to pediatric ERs found that Black children with mental health diagnosis were more likely to be admitted than their white counterparts (78.4 per 100,000 vs. 51.5), suggesting that they were not receiving the services needed until the situation reached crisis. Nationally, white children often receive treatment for mental health complications, while children of color are more likely to enter the juvenile justice system. Florida’s children of color need affordable access to culturally competent mental health services in schools or in their communities.

Mental Health Services for Children Are Not Readily Available, and Children Need Advocates

Children with mental illness and substance abuse problems often don’t have access to the critical services they need to live a healthy life, succeed in school, and remain out of the justice system. In the past two years, only 58% of Florida children who needed mental health care received services, leaving many children with mental health needs susceptible to the risks associated with untreated illnesses at an already vulnerable period in their lives.

The infusion of mental health dollars into public schools after the Parkland tragedy has provided some progress, but integration of such services with community mental health is inconsistent.

Too often, Florida’s mental health system is directed by stakeholders with financial interests, rather than professionals, patients, and researchers.The voices of Floridians relying on these support systems need to be heard for the state to ensure it serves its citizens’ mental health needs effectively and efficiently.

Failure to Address Mental Health Leads to Substance Abuse

Lack of mental health services can have lasting negative impacts on the life of a child. A study reported that 24.4% of people sampled reported that mental illness was a factor in currently experiencing homelessness. Additionally, without the appropriate support, children may turn to illegal substances to cope with mental health issues and homelessness. According to one study, 63% of youth receiving substance abuse treatment also had mental health issues.

Substance abuse is problematic for many reasons: it can hinder a child’s physical and mental development, influence children to engage in risk behaviors, such as unprotected sex, and lead to severe health problems in adulthood. The younger that children start using illegal substances, the more probable it is that they will continue abusing substances into adulthood. Substance abuse is extremely dangerous with the increased uptick of fentanyl overdoses.

Mental health support is critical to keeping children safe from illegal drugs. With the proper support, children are less likely to find themselves experiencing homelessness or needing to self-medicate with illicit substances.

Baker Act Hurts Children and Removes Parental Rights

The Baker Act allows doctors, mental health professionals, judges, and law enforcement to remove a student from the school in order to complete an involuntary mental health examination. Although this act was intended to help children that pose an imminent threat to themselves or others, in practice the Baker Act has been used as a catch-all action that has devastating impacts on children

Children who are involuntarily examined are detained, no matter their age, are forced to undergo thorough examination, and prohibited from contacting their families. These children can be involuntarily and legally detained without parental consent for up to 72 hours. During these 72 hours, the child cannot leave until a medical professional states they have met criteria to be properly discharged.

In Florida, there is no minimum age for a child to be detained and involuntarily examined. Having an involuntary examination can be traumatizing for a child. Students who are reported to law enforcement to initiate a Baker Act examination are typically examined on school grounds, detained, handcuffed, and removed by law enforcement in front of their peers. After

an involuntary examination, children can experience Post Traumatic Stress Disorder (PTSD), general anxiety, separation anxiety, depression, and emotional withdrawal. These traumatic events can follow a child for long after they are released from the mental health facility. They can fall behind in school and experience educational disruption, and gain a lasting fear of medical professionals, law enforcement, family, and adults.

Children that are released back home after such a traumatic event are met with a lack of mental health services. This worsens the effects of what they experienced. When mental health disorders are not treated, children are likely to have increased interactions with the juvenile justice system.

In the 2018-2019 school year, over 37,000 children received involuntary examinations statewide. In the same period of time, the number of students arrested in schools dropped over 50%. While lower arrest rates may initially seem positive, the numbers paint a grim picture. Rather than only Baker Acting the students that are experiencing serious mental health crises, the Baker Act is instead used as a first-resort disciplinary tool. In 2021, Florida law was changed to require school safety officers to undergo crisis intervention training, and requiring school districts to adopt procedures mandating de-escalation attempts prior to initiating a Baker Act and contacting a healthcare practitioner prior to a Baker Act being initiated. Changes also included increased data collection about the use of Baker Act in schools, and requiring schools to make a reasonable attempt to notify parents before their children were removed to undergo an involuntary examination. While this is a step in the right direction, the innumerable harms done to children and families by involuntary examination reflects a failure of the practice of utilizing the Baker Act. Increased mental health resources in schools, including access to psychologists, needs to take the place of involuntary institutionalization of young children, and much stronger protections must be put in place to prevent the abuse of emergency intervention.

Untreated Issues Lead to Justice System Involvement

According to Florida’s Department of Juvenile Justice, over 65% of the youth in the care of the Department of Juvenile Justice have a mental illness or substance abuse issue. Examined more closely, the data shows that 32.9% of all youth in custody have a history of mental health problems and 53.4% are currently using drugs. These numbers are disproportionately higher for girls with 48.8% of girls in custody having a history of mental health issues, and 55.7% abusing substances.

Treating mental health and substance abuse issues before a child enters the justice system could save the state an estimated $53,665 per youth. It would also avoid worsening mental health, as youth may develop trauma and trauma-induced disorders like PTSD that can compound their existing mental health needs.

Some children are provided with mental health services after they’ve made contact with the juvenile justice system, but it is not guaranteed. If children do receive services, those who have both mental health and substance abuse issues can be given incomplete care that only treats one of the problems in isolation. This can exacerbate many mental health problems and worsen substance abuse. Additionally, factors that contribute to mental health problems and justice system involvement jointly, such as Adverse Childhood Experiences including the traumatic stressors of juvenile justice involvement itself, are largely unacknowledged and untreated by the care that actually is provided for these children. Treatment of mental, behavioral, and substance disorders should be of primary importance in any system that aims to rehabilitate youth.

The Clinician Shortage Crisis

The uptick of mental health crises across the nation, due to experiencing the pandemic and the stress associated with the pandemic, has created a high need for mental health professionals. Unfortunately, there is a large disparity between the number of people who need help and the number of people who can provide it.

According to the Kaiser Family Foundation, Florida currently only serves 21% of the mental health needs, and would require more than 500 new clinicians to remove the designation of Health Professional Shortage Areas (HPSA) or places which lack sufficient health care services.

The shortage of mental health practitioners can have life threatening results considering that, even before the pandemic, there was a 27% increase in adolescent anxiety and a 24% increase in adolescent depression from 2016 to 2019. Mental health practitioners are pivotal agents of prevention regarding the current mental health crisis in the United States.

Support

  • Reverse the escalating use of the Baker Act on children which results in them being transported in handcuffs, without parental involvement, only to arrive at a receiving facility to be turned away because the majority don’t meet the criteria of the Baker Act.

  • Prioritize access to mental health services to keep children out of the child welfare system, reduce substance abuse, protect them from in-school danger, and prevent entry into the juvenile justice system.

Legislation

American Children’s Campaign Priority Bill Highlights

What American Children’s Campaign is Saying…

Additional Resources

  • Quick Facts: Substance Abuse and Mental Health—Department of Children and Families shows data on those receiving mental and health services in Florida per quarter.
  • The Baker Act 2019-2020 Annual Report—Louis de Parte Florida Mental Health Institute. Gives data on each county’s receiving facilities and examination numbers.
  • Report on Involuntary Examination of Minors—Department of Children and Families Office of Substance Abuse and Mental Health. Report analyzing data on involuntary examinations in Florida, studying root causes for any patterns or trends identified, and recommending alternatives to Baker Act initiations and eliminating inappropriate uses.

Disclaimer: These links to third-party websites are provided as a convenience and for informational purposes only. They do not constitute an endorsement or approval by American Children’s Campaign or its affiliate organizations and partners.