HHS $25M grant program would expand mental health care services in schools

Schools vying for a some of the $25 million the Department of Health and Human Services (HHS) will award to improve primary care must include mental health services in their programs, according to an HHS announcement.

HHS Secretary Xavier Becerra said that “ensuring that children can access the care they need in schools, including mental health services, is a critical way we can support their healthy growth and development.”

The grant money will be allotted through the Health Resources and Services Administration (HRSA). HRSA-funded health centers currently operate more than 3,400 school-based programs in the U.S. HHS plans to grant 70 awards with the $25 million.

HRSA Administrator Carole Johnson said in the announcement that “we want to ensure that there is no wrong door to young people finding help. That’s why we are investing in expanding mental health care in schools to help kids get the support they need. We look forward to a robust applicant pool in response to this exciting funding announcement.”

HHS officials reason that providing primary care services at school will widen the safety net for children. HRSA wants to use the money to build new school-based healthcare sites as well as expand already existing sites.

The press release states that “the $25 million funding opportunity for health centers announced today builds on the $30 million HRSA has awarded since September 2021 to increase access to health center services in schools.”

In a letter sent to the nation’s governors last year, Becerra and Secretary of Education Miguel Cardona wrote that “children have been particularly impacted by the COVID-19 pandemic, including significant impacts on their mental health. As of June 2021, approximately 140,000 children have lost a parent or grandparent caregiver to COVID-19. Youth reports of psychological distress have doubled since the pandemic began, with 25 percent reporting depressive symptoms and 20 percent reporting anxiety symptoms.”

The pandemic increased the possibility that even children just starting school might have mental health care needs. Becerra and Cardona wrote that the pandemic exacerbated trauma and adjustment disorders for children under 5 years old.

In addition, they wrote that “children and youth with intellectual or developmental disabilities and those with prior childhood trauma are at particular risk for pandemic-related mental health challenges, as are those who have faced previous discrimination in the health care system, including children and youth of color, immigrant children, children with disabilities, and those who are LGBTQ+.”

COVID-19 exacerbated mental health problems, but a report last year by the Employee Benefit Research Institute (EBRI) found that youth mental health problems were on the rise even before the pandemic struck. People 25 and younger make up 36% of the U.S. population, and, while they accounted for 20% of overall healthcare spending for 2020, they accounted for 42% of spending on mental health and substance abuse, according to the EBRI report.

The fact that EBRI did the study is in keeping with the growing concern that employers have about mental health.

Elizabeth Mitchell, president and CEO of the Purchaser Business Group on Health (PBGH), told Fierce Healthcare that employers aren’t so much concerned about paying for mental health benefits as they are about the state of the mental health safety net.

“It’s deeply dysfunctional,” Mitchell said. “The big problem is that there are too few mental health providers.”

PBGH comprises 40 large private and public employers that spend about $350 billion a year to cover 21 million Americans. PBGH has been asking health plans how they’re paying for mental health care that’s integrated into primary care.

“There is not adequate payment to primary care practices to integrate behavioral health,” Mitchell said.