Behavioral health concerns are common, no matter your age. They include conditions like anxiety, depression, substance use disorders, and others. Despite how common behavioral health issues are, stigma and limited access means people may not seek help when they need it.

These conditions can impact people of all ages, including kids – and the stats are heartbreaking:

• The Centers for Disease Control and Prevention (CDC) reported 1 in 5 children are suffering from poor mental health.
• The National Alliance for Mental Illness (NAMI) found nearly 50% of youth with a mental illness didn’t receive mental health services in the previous year.
• Families are 10 times more likely to go out-of-network for pediatric behavioral health care due to lack of providers or long wait times.

With the need for care reaching this level of crisis, what is being done to help improve access for young people?

Taking the first step

Often, a parent or child will first bring up behavioral health concerns with their pediatrician or primary care doctor.

Dr. Josephine Young, Medical Director at Premera Blue Cross, worked as a pediatrician in various settings for more than 20 years.

“It starts with a conversation,” she said. “I would ask about how things are going at school and with their friends, about their home and family, how they feel about themselves and what concerns they might have. And most importantly, how they would like to approach any issues that have been identified.” She noted it’s important to lay out the path for children to participate in their treatment plan. Being empowered in their own healthcare helps ensure they engage in their treatment.

Many kids may not regularly see a primary care doctor, though. In that case, they may confide in a trusted adult in their life. “Sometimes it’s talking to a family member, teacher, school counselor, neighbor, or coach,” Dr. Young explained. “It’s about having as many adults in the community as possible be receptive to having these conversations. You don’t know when a child or teen will open up and to whom. As adults, we need to be there for those moments.”

Finding help isn’t always easy

If a need for counseling is confirmed, the next step is getting an appointment with the right provider. However, it can be a daunting task for families to find a local therapist who is a personality fit with the right clinical expertise or has availability that matches their schedule. These are hurdles that can keep people from getting the care they need – and in the worst case, can lead to a crisis that requires emergency care.

Talking with a therapist is a very individual experience and everyone’s needs are met differently. “Being able to talk to someone who understands your background and culture or looks like you is significant,” Dr. Young explained. “Many people feel that having to educate a therapist on their perspective and lived experience is an added weight that doesn’t feel worth it. This is a very real problem that’s worsened by a lack of options in clinicians.”

Finding the right fit can be even harder in historically marginalized communities. According to a study by the American Psychological Association, 86% of psychologists are white and other behavioral health professions are similarly lacking in diversity. Plus, the American Journal of Preventive Medicine found that 65% of rural counties do not have a psychiatrist in the area and almost half do not have a psychologist.

Closing the gap

Reducing the time between a young person asking for help and getting into treatment, along with broadening provider options, can help break down the barriers to accessing quality care.

“When a young person finally works up the courage to go forward with therapy, you have to meet them where they’re at or you might lose them. You really have to capture the moment,” Dr. Young shared. “It’s that much harder if they are in a community where mental health is seen as a sign of weakness or a personal shortcoming, so acting quickly is important.”

Integrating behavioral health services into primary care clinics is one way to help shorten the amount of time it takes to meet with a clinician. With therapists on-site, a pediatrician can more easily connect kids with them in a familiar setting. This collaborative approach can ultimately lead to better overall health outcomes, too, because behavioral health and physical health are two halves of the whole health of an individual.

Virtual behavioral healthcare – sometimes called teletherapy or telemedicine – can open many doors when it comes to access. For many, it’s a faster and more convenient option. Kids don’t have to worry about transportation to and from appointments. They can talk to someone when it works for them and from wherever they are comfortable – whether it’s their bedroom or a friend’s house. It also offers more opportunities to find the right fit, especially for children who can’t easily find a therapist in their area who looks like them or they see as relatable.

There are a few models of virtual care available. Many doctors and therapists who work in physical offices started offering virtual services. This gives kids the flexibility of virtual appointments with the option to see someone in-person if needed. Premera includes several virtual-only options in our network, too. Therapists and clinicians from across the country can be part of these virtual platforms, offering a broad range of backgrounds and experiences. This presents young people with choices that may not exist in their local area due to a lack of providers.

The Premera provider directory offers the ability to filter by providers who offer a telemedicine option. Check our website for more details about the virtual-only options, too.

Dr. Young shared an important tip for everyone, especially those with young people in their lives. “If you encounter someone who says, ‘I think I need help,’ then ask them, ‘How can I help? How can I support you? Can I share this with anyone else?’” This is part of the important feeling of empowerment that makes young people an active participant in their care.

“I also want people to think about how amazing it can be for young people to understand their challenging experiences and expand their inner toolbox through therapy. By gaining these skills and insights, they can better address future concerns as they arise,” Dr. Young said.