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- House
Bill 1451
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Health Special Tax Districts
Key
Messages
- Invest
in young children's social and
environmental development
- Mental
health is fundamental to the overal
l health and well-being of young children
Resources
- Data
and Information
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About
the Blue Ribbon Policy Council
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Quick
Facts: National Data
(Adapted
from The National Center for Children in Poverty, Columbia University
Mailman School of Public Health's Children's Mental Health: Facts for
Policy Makers. For more Quick Facts go to http://nccp.org/pub_ucr06b.html.
)
Did
you know?
Mental/Emotional/Behavioral
- One in 5 children has
a diagnosable mental disorder (New Freedom Commission
on Mental Health. (2003). Achieving the promise: Transforming mental
health care in America. Final report (DHHS Pub. No. SMA-03-3832).
Rockville, MD: U.S. Department of Health and Human Services, Substance
Abuse and Mental Health Services Administration).
- One in 10 children
and adolescents has a mental illness that is severe enough to cause
some level of impairment. Only about one in five of them receives
mental health services in any given year (U.S.
Surgeon General's Conference on Children's Mental Health, 2000).
- Child mental disorders
can continue into adulthood. 74% of 21-year olds with mental disorder
had prior problems (U.S. Surgeon General's Conference
on Children's Mental Health, 2000).
- The onset of major
mental illness may occur as early as 7 to 11 years old (Kessler,
R.C., Beglund, P., Demler, O., Jin, R. & Walters, E.E. (2005).
Lifetime prevalence and the age-of-onset distributions of DSM-IV disorders
in the National Comorbidity Survey Replication. Archives of General
Psychiatry, 62(6), pp. 593-602).
- New data on
young children with diagnosable disorders reveal that about 17% show
some kind of significant mental health disorder, with rates varying
by problem. About 10% of them have acting out, agressive disorders
(Johnson & Knitzer, 2005).
Risk
Factors
- Poverty is
the greatest risk factor for poor developmental outcomes, whether
social, emotional, health related, or academic. Over 40% of all young
children are from families at or below poverty level, and half of
those live in extreme poverty (Johnson & Knitzer,
2005).
Mental
Health Treatment
- Most children and youth
with mental health problems do not receive needed services. 75-89%
of children and youth in need of services do not receive them
(Kataoka, S., Zhang, L. & Wells, K. (2002). Unmet
need for mental health care among U.S. children: Variation by ethnicity
and insurance status. American Journal of Psychiatry, 159(9),
pp. 1548-1555.
- Latino children and
youth are less likely to receive services for their mental health
problems than children and youth of other ethnic groups. 88% of Latino
children have unmet mental health needs. (Kataoka,
S., Zhang, L. & Wells, K. (2002). Unmet need for mental health
care among U.S. children: Variation by ethnicity and insurance status.
American Journal of Psychiatry, 159(9), pp. 1548-1555).
- 31% of white children
and youth receive mental health services (Ringel,
J.S. & Sturm, R. (2001). National estimates of mental health utilization
for children in 1998. Journal of Behavioral Health Services &
Research, 28(3), pp. 319-333).
- 13% of children from
diverse racial and ethnic backgrounds receive mental health services
(Ringel, J.S. &
Sturm, R. (2001). National estimates of mental health utilization
for children in 1998. Journal of Behavioral Health Services &
Research, 28(3), pp. 319-333).
- 85% of children and
youth in need of mental health services in the child welfare system
do not receive them (Burns, B., Phillips, S., Wagner,
H., Barth, R., Kolko, D., Campbell, Y. & Yandsverk, J. (2004).
Mental health need and access to mental health services by youths
involved with child welfare: A national survey. Journal of the
American Academy of Child and Adolescent Psychiatry, 43(8), pp.
960-970).
- 79% of children with
private health insurance and 73% with public health insurance have
unmet mental health needs. 87% of children who are uninsured have
unmet mental health needs. (Kataoka, S., Zhang,
L. & Wells, K. (2002). Unmet need for mental health care among
U.S. children: Variation by ethnicity and insurance status. American
Journal of Psychiatry, 159(9), pp. 1548-1555).
Pre-School
and Educational Settings
- Overall, over
10% of young children entering kindergarten are rated by teachers
as showing some degree of behavioral problems. In samples of low income
young children, reported rates of behavioral problems are often two
to three times higher (Johnson & Knitzer, 2005).
- Pre-school
children face expulsion rates three times higher than children in
kindergarten through 12th grade - a factor party attricbuted to lack
of attention to social-emotional needs (Gilliam,
W.S. (2005). Prekindergartens left behind: Expulsion rates in state
prekindergarten programs (FCD Policy Brief Series 3). New York,
NY: Foundation for Child Development).
- African-American
preschoolers are 3 to 5 times more likely to be expelled than their
white, Latino, or Asian-American peers (Gilliam,
W.S. (2005). Prekindergartens left behind: Expulsion rates in state
prekindergarten programs (FCD Policy Brief Series 3). New York,
NY: Foundation for Child Development).
- Children and
youth in elementary school with mental health problems are more likely
to be unhappy at school, be absent, or be suspended or expelled. In
the course of the school year, they may miss as many as 18-22 days.
Their rates of suspension and expulsion are three times higher than
their peers. Among all students, African-American students are more
likely to be suspended or expelled than their white peers (40%
vs. 15%) (Blackorby, J. Cohorst, M., Garza, N.
& Guzman, A. (2003). The academic performance of secondary school
students with disabilities. In The Achievements of Youth with Disabilities
During Secondary School. Menlo Park, CA: SRI International).
- Youth in high
school with mental health problems are more likely to fail or drop
out of school. Up to 14% of them receive mostly Ds and Fs (compared
to 7% for all children with disabilities (Blackorby,
J. Cohorst, M., Garza, N. & Guzman, A. (2003). The academic performance
of secondary school students with disabilities. In The Achievements
of Youth with Disabilities During Secondary School. Menlo Park,
CA: SRI International). And, up to 44% of them drop out
of school (Wagner, M. (2005).
Youth with disabilities leaving secondary school. In Changes Over
Time in the Early Post School Outcomes of Youth with Disabilities:
A Report of Findings from the national Longitudinal Transition Study
(NTLS) and the National Longitudinal Transition Study-2 (NTLS2) (pp.
2.1-2.6). Menlo Park, CA: SRI International).
Child
Welfare and Juvenile Justice
- Children with
mental health issues in the child welfare system are less likely to
be placed in permanent homes (Smithgall, C., Gladden,
R.M., Yang, D.H. & George, R. (2005). Behavioral problems and
educational disruptions among children in out-of-home care in Chicago
(Chapin Hall Working Paper). Chicago, IL: Chapin Hall Center for Children
at the University of Chicago).
- They are also
more likely to be placed out of home in order to access services
(Hurlburt, M.S., Leslie, L.K., Landsverk, J., Barth,
R., Burns, B., Gibbons, R.D., Slymen, D.J., & Zhang, J. (2004).
Contextual predictors of mental health service use among children
open to child welfare. Archives of General Psychyiatry, 61(12),
pp. 1217-1224).
- They are more
likely to over rely on restrictive and/or costly services such as
juvenile detention, residential treatment, and emergency rooms (U.S.
House of Representatives, Committee on Government Reform, Minority
Staff Special Investigations Division (2004). Incarceration of
youth who are waiting for community mental health services in the
United States (Report prepared for Rep. Henry A. Waxman and Sen.
Susan Collins). Washington, DC: U.S. House of Representatives, Committee
on Government Reform; Pottick, K. Warner, L.A. & Yoder, K.A. (2005).
Youths living away from families in the US mental health system: Opportunities
for targeted intervention. Journal of Behavioral Health Services
& Research, 32(2), pp. 264-281; and Almgren, G. & Marcenko,
M.O. (2001). Emergency room use among foster care sample: The influence
of placement history, chronic illness, psychiatric diagnosis, and
care factors. Brief Treatment and Crisis Intervention, 1(1),
pp. 55-64.)
- Young adults
leaving the child welfare system experience major mental healht problems
and drug and alcohol dependence at significantly higher rates than
the general population (Pecora, P.J., Williams,
J., Kessler, R., Downs, C., O'Brien, K., Hiripi, E. & Morello,
S. (2003). Assessing the effects of foster care: Early results
from the Casey National Alumni Study. Seattle, WA: Casey Family
Programs).
Cost:
- For every
dollar spent on Early Childhood Education, between $4 and $13 are
saved over time on special education, health care, "welfare"
payments, and criminal justice (Barnett, N.D.).
- The average
cost of providing a year of Head Start for one child is $5,403 (North
Carolina Legislative Advocacy Workbook, 2003).
- The average
cost of keeping a person in prison for one year is $20,000 (North
Carolina Legislative Advocacy Workbook, 2003).
- Every year
we allow a child to grow up in poverty costs $9,000 in lost future
productivity over his or her working life (North
Carolina Legislative Advocacy Workbook, 2003).
- According
to a national study, the nurse home visitation program costs $7,733
per participant, but the benefit to taxpayers is $15,918 per participant.
In other words, for every $1 invested, taxpayers receive a benefit
of $3.06 (Aos, Phipps, Bamoski & Lieb, 2001).
- According
to that same national study, for early childhood education for disadvangated
youth taxpayers receive a benefit of $1.78 for every dollar invested
(Aos, Phipps, Bamoski and Lieb, 2001).
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