Over the past year, CCC with the support of our Learning Collaborative held several conversations with child and family serving professionals and community members about the policy and budget solutions they hoped to see prioritized to help families overcome the challenges they now face. Through these conversations, we’ve heard from New Yorkers about their experiences during the pandemic, the impact on their lives and the communities in which they live, and the solutions needed to advance equity and recovery for all children and families. Read more from our “Conversations with New Yorkers on Pandemic Response & Recovery” series here.

In the year since New York first shut down, parents and young people have experienced the loss of loved ones, disruptions in education, increased food and housing insecurity, social isolation, and skyrocketing behavioral health needs.

Supports to address social connection and behavioral health needs for both children and young adults have been of critical concern for parents and advocates during the pandemic. Stephanie Portillo, a Community Organizer with the Hunts Point Community Partnership Program at the Hunts Point Alliance for Children, supports the community by identifying needs and connecting families to information and services that support child development from prenatal to age eight.

Describing Hunts Point as a very industrialized neighborhood with residents that are tight knit, family oriented and diverse – Stephanie says that children are especially in need of support under quarantine and remote learning conditions.

She explains this through concerns she and other parents raise about how isolation and remote environments contribute to a sense of detachment in children, influencing their development. “Talking to people on a screen 24/7 – that changes how you interact with people,” she said. “A lot of parents have brought up this as well, focusing on their kids to have those social skills – knowing how to talk to people and knowing that they can play and enjoy life regardless of what is happening, but doing it safely.”

Even prior to the pandemic, New York had a children’s behavioral health crisis and the need for services throughout the state vastly outstripped supply. In instances where access to behavioral health supports were not readily available, schools would often fulfill that need for children and youth. The combination of school closures and hybrid learning models has disrupted access to valuable resources of educational support, behavioral health, and other preventive services, especially in underserved communities.

For Maritza Cuevas at the Staten Island Alliance for North Shore Children and Families, her focus centers on the impact of social isolation on teens and young adults. In the aftermath of the first stretch of the pandemic in 2020, she noticed the emerging challenges, with decreased social interaction, that included increased anxiety and even depression among youth.

“You’re talking young people” she says, “they want to do things, the weather is nice, they want to go out, they miss the city, and they miss interacting with their peers and their families.”

The Pandemic Has Heightened Need for Social-Emotional and Mental Health Supports

New York’s youth are experiencing a spike in reported symptoms of anxiety and/or depression that are consistently higher than other age groups. From June to July, almost half of all youth aged 18 to 24 living in the New York metropolitan area reported symptoms of anxiety and/or depression.

When surveyed from August to October 2020, reported symptoms rose to 55 percent for the same age group. Data from this same period show that among all adults experiencing symptoms of anxiety and/or depression, only 20% report receiving counseling or therapy from a mental health professional over the last month.[1]

Among children and youth under eighteen, hospitals and medical centers have also reported dramatic increases in mental health related care. Between 2019 and 2020, children’s mental health related emergency visits as a proportion of all pediatric emergency visits across the United States increased by 24 percent for children ages 5-11 and 31 percent for youth ages 12-17, according to the CDC.[2]

In addition, children and families have experienced significant decline in critical primary and time-sensitive preventive services for children between March and May 2020 leading to 44 percent fewer (3.2 million) child screening services across the country compared to 2019.[3] These critical services include those that assess physical and cognitive development needs and can provide early detection of autism, developmental delay, and other conditions.

Limited access to services and social isolation during the pandemic are likely factors. However, we must consider other factors that may affect children and youth as well. Data from the Census Bureau 2020 Household Pulse Survey found that reported symptoms of anxiety and/or depression – particularly among Black and Hispanic/Latino youth – spiked the week following the murder of George Floyd on May 25^th.

During times like these our communities, adults, youth and children need social and emotional supports to get through what can be both personal and community trauma. Yet access to some types of behavioral health services can be limited.

“It would have been really nice if we have some mental health [services] inside of Hunts Point where families can walk two or three blocks and take their kids to see a psychiatrist or a therapist to get some help,” says Carmen Rodriguez, Community Ambassador for the Hunts Point Community Partnership Program.

In light of the heightened needs experienced by children and families, organizations and initiatives in communities throughout the five boroughs have worked to improve awareness, access, and/or delivery of behavioral health supports.

For our partners at the Staten Island Alliance for Children and Families (the Alliance) a significant portion of their efforts have been focused on setting up a Young Child Wellness Council through their partnership in Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health). The project is aimed at promoting the wellness of young children ages birth to 8 by addressing the physical, social, emotional, cognitive, and behavioral aspects of their development.

Examples of their work include utilizing Community Health Workers during the pandemic to conduct outreach and engage parents and children in the community with a focus on care coordination, linking children and families to resources, and providing parent education – often through home visits (with safety precautions) to support and widen their presence in the community. Through Project LAUNCH, the Alliance increased access to available screening assessments, referrals, and treatments for behavioral health treatment and early intervention services for the North Shore community.

The Alliance also worked to navigate the challenges of providing access to needed behavioral health supports and services by engaging partners and families in regularly organized “Community Conversations.” In partnership with the NYC Department of Health and Mental Hygiene, these conversations covered topics such as the pandemic’s impact on mental health, the health disparities that exist in communities of color, the effects of trauma, grief and anxiety, and the coping skills and resources that are available. Alliance members and staff were also trained to support the increased needs children and families were facing including suicide prevention and safety planning, stigma and racial bias training and care for the caregivers.

After a year of anxiety, isolation, loss of loved ones, disconnection from school, and economic insecurity, New York’s children need a coordinated and comprehensive approach to meeting their behavioral health needs.

As state leaders are in the final days of negotiations for the fiscal year 2021-22 budget, we are advocating with our partners on the Campaign for Healthy Minds, Healthy Kids to ensure that the Enacted Budget includes important protections and investments in children’s behavioral health.

Fortunately, both the Senate and Assembly have rejected across the board cuts to Medicaid and local aid in their one house budgets, and the Executive Budget calls for significant investments in telehealth services which have been a critical resource for families during the pandemic. Continued advocacy is needed to ensure the Enacted Budget maintains these proposals as well as invests federal funding dedicated to mental health and substance use from the December stimulus and the American Rescue Plan towards services for children and families.

We are also advocating to support the Assembly’s proposal to cover more behavioral health services in the Child Health Plus Program (CHP), specifically new services known as Children and Family Treatment and Support Services (CFTSS). You can join us in advocating for these investments which are crucial to support families in recovering from the impact of the pandemic by writing your state representatives today.

With City budget hearings underway, we are advocating for city leaders to dramatically increase school-based behavioral health supports, restore and enhance funding for community-based behavioral health supports, and restore cuts to Community Schools, SONYC, and other education services that provide essential wraparound and behavioral supports for students.

In addition, with new federal resources for education and child care coming to localities, the city’s leaders have the opportunity to ensure New York’s students benefit from a holistic approach to combatting learning loss and supporting their health and well-being. We are also calling on the Mayor and City Council to ensure the upcoming budget saves summer camps and invests in a robust continuum of year-round youth programs – starting this summer – that will be crucial to supporting youth after a year of disconnection and social isolation.

Please raise your voice with us to continue advocating to ensure that investments are made at every level of government to support a full recovery for all New York’s children, youth and families.

Sources:

[1] CCC analysis of U.S. Census Bureau Household Pulse Survey, Public Use Files August 19 – October 26, 2020. Retrieved from: https://www.census.gov/data/experimental-data-products/household-pulse-survey.html

[2] Leeb RT, Bitsko RH, Radhakrishnan L, Martinez P, Njai R, Holland KM. Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1675–1680. DOI: http://dx.doi.org/10.15585/mmwr.mm6945a3

[3] CMS Issues Urgent Call to Action Following Drastic Decline in Care for Children in Medicaid and Children’s Health Insurance Program Due to COVID-19 Pandemic | CMS. (2020, September 23). Centers for Medicare & Medicaid Services. https://www.cms.gov/newsroom/press-releases/cms-issues-urgent-call-action-following-drastic-decline-care-children-medicaid-and-childrens-health