Behavioral Health Integration
Low-Income Children Are At Risk For Behavioral Health Issues
Colorado is coming together around the concept that moving children out of poverty is needed to revitalize our society. An important step in that process is to address the mental and emotional needs of children living in poverty. Children in low-income families are at higher risk for behavioral health (also known as mental health) issues due to a variety of factors: the toxicity of poverty, the many socioeconomic factors the family faces, the higher incidence of post-partum depression in the mother, the higher degree of stress in these families, and the delays in identifying and treating developmental delays, depression and other behavioral issues. Many children on Medicaid have access to behavioral health counseling in community mental health centers, but only a small proportion of referred families actually obtain the help they need due to a sense that mental health care carries a stigma or due to the any of the many psycho-socio-economic barriers described above.
Young Minds Matter:
Supporting Children’s Mental Health Through Policy Change
CCHAP’s Behavioral Health Vision And Goals
Behavioral health is a major focus area for CCHAP and will be a priority over the coming years. CCHAP’s behavioral health vision is that all children in Colorado will have early access to comprehensive, preventive behavioral health care in their medical home. The CCHAP goals for comprehensive preventive behavioral health care of children parallel the goals of the Colorado State Health Innovation Plan.
- By 2019, 80% of medical homes for children will have an integrated behavioral health care provider.
- By the end of 2016, 76% of medical homes for children will have incorporated evidence-based methods for providing preventive behavioral health care including early screening, early intervention, appropriate care coordination and attention to socioeconomic barriers.
CCHAP provides education, technical assistance and coaching for medical homes that care for children on Medicaid and CHP+ to implement comprehensive preventive behavioral health services to address behavioral health disparities.
- A child with behavioral health problems costs the health care system 5 times as much as a child without behavioral health problems (Center for Health Care Strategies, CHCS)
- Access to behavioral health services is much lower in families with limited English proficiency, families in minority cultures and families of color. (National Ambulatory Medical Survey)
- The myriad psycho-socio-economic issues faced by low income families create stress, which is now being shown as toxic, adversely affecting brain development and emotions of young developing children. There is a growing scientific knowledge base that links poverty with “childhood toxic stress” and there is evidence that the disruption to the development of the brain and behavioral health issues caused by the stress of poverty can lead to lifelong impairments in learning, behavior and behavioral health. (Harvard Center on the Developing Child; National Scientific Council on the Developing Child; American Academy of Pediatrics; Early Childhood Colorado Partnership)
- Socioeconomic conditions that are toxic to a child’s behavioral health, called social determinants of behavioral health, are also barriers to access and follow through on behavioral health care.
- Social determinants of behavioral health include: low income, food insecurity or poor access to healthy foods, adequate housing, transportation, social support network, education, employment, physical environment, unhealthy environmental exposures, social environment, unsafe neighborhoods, lack of clothing, loss of utilities, family stress, family violence, legal problems, substance abuse and cultural differences.
- Additional risk factors for behavioral health problems include: parents with behavioral health problems, a mother with post-partum depression, single parent households, lack of parenting education, a parent in the justice system, a child in the welfare system, and foster care.