May is Mental Health Awareness Month. Fittingly, addressing the mental health needs of children and youth in the United States has become an issue of bipartisan concern. According to the Centers for Disease Control and Prevention (CDC)’s Youth Risk Behavior Survey, 42 percent of high school students report persistent feelings of sadness or hopelessness, and 22 percent reported seriously attempting suicide in 2021. It is much worse for girls. It is also far worse for youth with special needs, such as LGBTQ youth and youth in and aging out of foster care. At least 21 states and the District of Columbia ban conversion therapy for LGBTQ minors. The effects of the COVID-19 pandemic have been cited as major factors in the growing problem, as has the influence of social media.
To address this crisis among youth with foster care experience, CRISP joined the National Foster Youth Institute co-sponsoring a congressional briefing last week on alternative mental health treatments for youth with foster care experience. Experts report that as many as 80 percent of youth with foster care experience have significant mental health issues, compared to 18 to 22 percent of the general population. Most youth with foster care experience live complicated lives that are disruptive at an early age, and they continue to take on additional stressors as they age and move through the system. Most are insured through Medicaid, which excludes a wide range of mental health treatments such as art therapy, music therapy, yoga therapy, and equine therapy, readily available to higher-income households. Medicaid generally limits treatment to talk therapy, which simply does not work for many experiencing foster care.
A panel of experts on alternative mental health treatment provided testimony on the effectiveness of treatments other than talk therapy. However, the most poignant testimony was that of Tina Harris, an NFYI Youth Delegate who told her story about receiving mental health treatment during her years in foster care. She was being treated by a conventional therapist who diagnosed her with schizophrenia. During the formative years of five to nine years old, she was heavily sedated and often made to do a timeout by sitting in a corner and facing a wall. Her “treatment” kept her in a state of anxiety. She moved to New Mexico and began treatment with a nonconventional therapist who included taking walks and playing chess. She began equine therapy which changed her life.
She developed a nonjudgmental relationship with the horse that occurred at her pace, which is one of the key elements of equine therapy, explained panelist Lisa Krystosek, the Governance Committee Chair of the Equine Assisted Growth and Learning Association (Eagala). She further explained that equine therapy is special because it works quickly and has lasting benefits. Clients develop a relationship with the horse that can be translated into other areas of their lives. She stressed that equine therapy is not a fly-by-night practice and that therapists are required to log 6,000 hours prior to certification. The practice has worked well with veterans.
Congresswoman Sydney Kamlager, who succeeded Karen Bass in representing California’s 37 District, touted the fact that the effort to improve the lives of young people with foster care experience was indeed bipartisan. She urged participants who were going to canvas congressional offices to arm themselves with the stories of those they are advocating for. “I think it is just so important to focus on the stories, on the successes, and when you are talking about the successes, to talk about how hard it was for them to be realized.” She promised to be a staunch ally and partner.
The bill that she will introduce in the coming days would fund a five-year demonstration project that will:
- Develop an evidence base for the success of alternative treatments for youth with foster care experience,
- Establish guidance for states, tribes, and territories on best practices to reduce and eliminate barriers to those treatments, and
- Propose policies and procedures to support braided funding mechanisms and billing codes through Medicaid and Title IV-E to ensure full reimbursement of the actual cost of covered therapies for foster youth.
As states continue racing to the bottom to lower taxes to attract business (think Texas and Florida) and limit social service spending to discourage an influx of those in need, it is incumbent upon social workers to be effective advocates for an adequate response by the federal government to the needs of vulnerable populations.