Homework answers / question archive / Running Head: US TEENAGE MENTAL HEALTH Policy Paper: US Teenage Mental Health 1 US TEENAGE MENTAL HEALTH 2 Introduction Mental health as per the World Health Organization is defined as a state of well-being where an individual is able to realize their potential, cope with the normal stresses of life, work productively, and contribute to societal development

Running Head: US TEENAGE MENTAL HEALTH Policy Paper: US Teenage Mental Health 1 US TEENAGE MENTAL HEALTH 2 Introduction Mental health as per the World Health Organization is defined as a state of well-being where an individual is able to realize their potential, cope with the normal stresses of life, work productively, and contribute to societal development

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Running Head: US TEENAGE MENTAL HEALTH Policy Paper: US Teenage Mental Health 1 US TEENAGE MENTAL HEALTH 2 Introduction Mental health as per the World Health Organization is defined as a state of well-being where an individual is able to realize their potential, cope with the normal stresses of life, work productively, and contribute to societal development. Poor mental health and mental illnesses, also called mental health disorders, is a term used to refer to a wide range of mental health conditions such as depression, schizophrenia, anxiety disorders, addictive behaviors, and eating disorders (Mental Health America, 2020). They alter a person’s thinking, behavior, feeling, and mood and profoundly affect day-to-day living as well as how the sufferers relate with others. Mental health conditions are not necessarily the result of an event. Research shows that they are an outcome of a combination of factors such as genetics, lifestyle, and the environment in which one lives. Stressful environments and traumatic life events make people more susceptible to mental disorders. Teenage is a critical period for mental, emotional, and social development. During adolescence, the brain goes through significant developmental transformations as it establishes neural pathways and behavior patterns that endure into adulthood. Due to the developing brain, teenagers are very receptive to positive social and emotional learning, and behavioral modeling. However, hormonal changes that accompany their brain development make them susceptible to conditions such as depression, and engagement in risky behaviors, and are core to their mental wellbeing. Mental health disorders become more complex and pronounced as children transition into adolescence. If left untreated, they lead to negative outcomes and life experiences such as poor performance in school, strained relationships at the family and society level, hazardous sexual US TEENAGE MENTAL HEALTH 3 behavior, and drug and substance abuse. In extreme cases, it leads to involvement with juvenile justice. This policy paper assesses the background and current state of mental health among teenagers in the United States. The paper is a recognition that through policy interventions, the US can combine medical and behavioral approaches in order to address the problem of mental health disorders among teenagers. The cost of mental health in the US is very high. In 2019 alone, the government spent $225 billion, an increase of 52.1% in one decade since 2009( Open Minds, 2020). The policy paper proposes policy interventions, which if implemented could save the country up to $67.8 billion per year. The current State of Affairs Mental health disorders prevalence Mental illnesses are common occurrences among teenagers in the US. Statistics indicate that they affect 46% of teenagers (Mental Health America, 2020). An estimated 20% of teenagers are diagnosed with a mental disorder. Between 20% and 30% present one major depressive episode before they grow into adulthood. 50%-70% of the teenagers exhibit anxiety disorders and impulsive control disorders like ADHD (Attention-Deficit/Hyperactivity Disorder) and conduct disorder. Suicide, often an outcome of mental illness, is the third leading cause of death among US teenagers. The rising trends of mental health disorders and the big treatment gaps noticed among American teenagers are alarming. Data from the National Survey on Drugs and Health approximated that 13.3% of US adolescents aged 12-17 registered at least one episode of a major depressive disorder in 2017. Of these individuals, only 60.1% received no treatment for their US TEENAGE MENTAL HEALTH 4 illness. In addition, a survey carried out by the Centers for Disease Control and Prevention revealed that the number of high school students going through persistent sadness and disillusionment had gone up from 26% in 2009 to 37% in 2019. Those harboring suicidal thoughts rose from 14% to 19%, planned suicide from 11% to 16%, and suicide attempts from 6% to 19% within the same period (NHIM, 2020). The most vulnerable were whites, females, and sexual minority students in comparison to non-white, male, and heterosexual students. The condition has been exacerbated by the COVID-19 pandemic with more cases of poor mental health and mental illnesses associated with the effects of the pandemic reported across the country (Loades et al., 2020). Initial results from studies show that the crisis occasioned by the pandemic has increased the risk for mental illness among teenagers with pre-existing psychological problems. There are increased cases of depression, anxiety disorder, and PTSD. Studies carried out in 2020 revealed that the worst spikes in mental illness happened during the initial phase of the pandemic, in March and April. In these two months, the US recorded an increase in claims for mental health disorders by 100% for 13-18-year-olds. The number came down to 50% in May and 30% through the summer, settling at 20% by the close of the year (NIMH, 2021). This has mainly been because of the lockdowns and closure of schools that have reduced access to mental health screening and care provision for at-risk students. The number of teenagers who receive such services in school settings stands at 3.5 million, and for many of these teenagers, the school setting is the only source of mental health services, especially those who come from low-income households as well as ethnic and racial minority groups. Barriers to the Attainment of Mental Health In America, 25% to 33% of teenagers forego requisite care for mental health while many others have no access to care (NIHM, 2021). Of all teenagers with mental health needs, only US TEENAGE MENTAL HEALTH 5 30% receive the needed care. An examination of barriers to treatment and access reveals various factors. The leading factor as to why teenagers do not access mental health care is because they are uninsured or have limited insurance. In the US, teenagers account for 25% of the approximate 8.3 million uninsured children. Close to 50% of State Child Health Insurance Program services place caps on inpatient and outpatient mental health services (American mental Health, 2020). There is also a dearth of referral services and specialists with training in dealing with teenage mental health issues. Moreover, the political system is reluctant towards allocating public funds towards mental health services. Thus, many teenagers with mental illnesses receive poor quality care or find it difficult to receive any kind of care. Studies reveal that 31% of these teenagers with mental illnesses try to access mental healthcare but have no idea where to go for help. Another factor is the stigma and discrimination associated with mental illness. Negative stereotypes and beliefs concerning mental illness have been a basis for bullying teens who have mental illnesses (Child Mind Institute, 2020). Bullying may be physical, verbal, social, or even cyberbullying. Besides, teenagers with mental illnesses are treated differently or poorly, often given fewer opportunities for education, employment, and even social activities. Stigmatization from family, peers and society in general negatively impacts these teenagers as it aggravates their condition through isolation, shame, and secrecy. These negative reactions become barriers to their seeking treatment. Studies reveal that 49% of American teenagers worry a lot about others judging when they seek mental health services. They also shy away from the health care services because of feelings of shame. US TEENAGE MENTAL HEALTH 6 Besides, how the media represents mentally ill individuals bears on how the public perceives the conditions. Unfortunately, the media often represents mentally ill people in an inaccurate and violent manner. A study published in 2020 considered the film ‘Joker’ (2020) and found that the lead character is an individual with a mental illness who becomes extremely violent. Viewing the film increased the levels of prejudice towards mental illness (Child Mind Institute, 2020). A teenager watching ‘Joker’ is likely to stigmatize their fellow teenager with the condition, while a mentally ill teenager who watches the film is likely to suffer from self-stigma which can lead to withdrawal from social interactions and even suicide. Deficiencies in Current Policy Many players in health care observe that when it comes to issues of mental health among teenagers, the government that is supposed to protect them has failed them. Health care facilities in their emergency departments are overwhelmed by cases of teenagers in psychological distress (NIHM, 2021). Yet, only 40% of the teens seeking treatment of mental health problems are able to get it, and the percentage even smaller if the teenager belongs to a racial, ethnic, or sexual minority, or worse still if they are involved in child welfare or the criminal justice system. It is equally difficult for teenagers who are hooked to drugs and alcohol. One out of three high school students has been reported to experience hopelessness and sadness, especially during the COVID-19 pandemic. Current policies on children and teenage mental health are deficient as policymakers seem unaware of the fundamental challenges that families with teenagers who suffer from mental illnesses face (Child Mind Institute, 2020). Without such critical information, it is difficult for teenage mental health advocates to effectively push their agenda. US TEENAGE MENTAL HEALTH 7 One of the achievements in the US teenage mental health policy reform in recent years has been the emphasis laid on the application of public health approach to policy development which has seen states support the promotion of mental health, prevention of mental health problems programs, as well as intervention and treatment measures. However, since mental health treatment is highly unpredictable, many states underfund such initiatives and the cost of mental health becomes a barrier for access and treatment among teenagers. That mental health requires enhanced financing is undisputable. Policy options must therefore focus on ways of enhancing the financing of mental health services in order to make them affordable and accessible for the majority of teenagers who present with such problems. Another policy option available is that states are required to improve service delivery capacity in public health systems so as to drive improved quality. This is to be achieved by adopting effective good practice strategies and enhance accountability through the reporting of outcomes. The weakness in this policy is that there are no clear-cut evaluation procedures that make it possible for accountability to be tracked. Consequently, data on mental health provision performance is a dearth, which compromises decision-making in matters related to mental health care. Besides, while there is a quality framework that has been recommended by the Institute of Medicine to ensure the provision of quality mental health services, funding for the framework is deficient which compromises the quality of its operations. States reimburse only specific mental healthcare services while most are left to the patient to pay out of their pockets (Cooper et al., 2015). This has contributed to making health care expensive and acted as a barrier to access and treatment of mental illnesses, thus increasing the prevalence and severity of the disorders. The nation also provides for the prevention and early intervention for children and teenagers as guided by the Before Stage Four philosophy. By this policy, it is required that US TEENAGE MENTAL HEALTH 8 mental health conditions be prevented or treated in good time so that they do not escalate to critical points in the development of the disease (Mental Health America, 2020). To achieve this, programs are in place to share information on mental health and how the policy should be implemented, particularly in schools through school-based education, teenage peer support structures, and in-school mental health services. This is also expected to go hand-in-hand with value-based payment and other reimbursement incentives. This has however remained a challenge especially because of limited funding, restrictions by insurers, and lack of experts with skills and willingness to work with teenagers in the provision of mental health services. As result, many teenagers are still unable to access care and treatment for mental health problems. Statement of Policy Suggestions In June 2019, 45 national and local advocates and policy experts in the US gathered in Washington D.C. for a national Summit for Policy and Action on Teen Mental Health Crises. The main objective of the summit was to come up with high-priority policy activities that would fix the gaps in the teens in crisis safety nets. They agreed that the teens’ mental health systems need an all-out overhaul. The mental health service system underpins the response to the teenage mental illness crisis. Mental health service needs for teens remain deficient in multiple facets. They are deep and broad, whether it is in the promotion of mental health or treatment. The persistence of these gaps remains a costly affair for the government (Academy Health, 2019). However, there is some light at the end of the tunnel. Current Congress has proposed legislation to increase funding for teen mental health crisis response. In the 2020 fiscal year, the House of Representatives set aside a $35 million block grant for labor, education, health, and human services appropriation bill. The health system needs more funds and a systematic, coordinated approach in order to US TEENAGE MENTAL HEALTH 9 efficiently and effectively serve the mental health needs of teenagers and avert the prevalent mental crisis. In view of this, this policy paper suggests the following as policy recommendations to mitigate the problem: Policy Recommendation I: Adequate Funding for Mental Health The federal government in conjunction with state and local governments should come up with well-funded health prevention and response systems that promote multisector communication and collaboration that will enhance teens’ better access to high-quality resources that are responsive to their unique mental health needs (Academy Health, 2019). In order to achieve this, federal and state governments should: ? Provide funds for teens’ programs that promote better decision-making skills and offer positive models for behavior to aid in the reduction of risk-taking behaviors. Teenagers are very resourceful and resilient and quite responsive to strategies that engage them meaningfully and help in the provision of a social support establishment. ? Provide funds to cascade comprehensive school-based health centers across the nation, especially those that offer mental health services. Enhanced access to on-site, school-based mental health services provided in school-based health facilities raises the likelihood that adolescents will access and receive mental health care. ? Fund effective, evidence-based prevention and early intervention strategies for health and behavioral health in schools. The US government spends a minimum of $700 billion annually on preventable adolescent health illnesses. US TEENAGE MENTAL HEALTH ? 10 Fund effective, evidence-based education programs that aid parents in the recognition of mental health problems in their children (Moon, 2017). When parents are deficiently informed about teens’ mental health problems, it becomes difficult for them to seek treatment. Policy Recommendation II: Legislation of Confidentiality There is a need to introduce legislation that enhances confidentiality protection so as to encourage teens’ access to confidential services. Inconsistency and lack of clarity in policies that affect teenage patient confidentiality can be barriers to mental health care. Research has revealed that of all adolescents who have depression, only 45% would seek care if there was a need for parental notification. Policy Recommendation III: Increase and Diversify Health Care providers Workforce There should be enough funds provided that aid in the attraction, training, and retention of a workforce with greater diversity in health care provision. Cultural differences between patients and health care providers can result in misdiagnosis of significant mental illness. At the same time, research shows that ethnic and gender matching between patients and health care providers lowers dropout rates in mental health treatments. While teenagers in mental health crises require expert help, very little is known about the extent of teen-related expertise among mental health care providers. Families, schools, and health care facilities struggle with shortages of mental health professionals who have the skills and are willing to work with teenagers (Academy Health, 2019). Available data reveals that the number of primary care physicians who are board-certified specialists in adolescent medicine and therefore allowed to see adolescents is below 1%. US TEENAGE MENTAL HEALTH 11 Consequently, it behooves the federal government to set targets at local, state, and national levels for the expansion of the number of adolescent specialists in primary, mental, and behavioral health, and addiction problems. The government should introduce funding mechanisms that support needed services, particularly in places that increase access like schools, youth centers, and adolescent-specific health and wellness centers. Restrictions imposed by insurers, inadequate funding, and poor prioritization for resources are amongst the key barriers to access of teenagers to the mental health care services needed for the treatment of mental health disorders. Policy Recommendation IV: School and Community Collaboration There should be a greater interprofessional collaboration between schools and communities initiated by state education agencies and mental health programs set up in schools to tackle the growing mental health needs of students (Hertz, 2020). 60% of teenagers with mental health needs do not access care or treatment due to barriers such as lack of insurance, cost of mental health care, and lack of appropriate mental healthcare services in communities. The use of schools as hubs for mental health services would make it possible for many of these teenagers to access treatment. This can be achieved through collaboration between school and community health care providers for the provision of comprehensive mental health care that would improve outcomes for teenagers (Curran, 2018). It will also enhance the identification of youth with mental health problems. Having mental health care services in school not only access but also reduces racial and ethnic disparities in access and treatment services. Policy Recommendation V: Training of Law Enforcement Agents US TEENAGE MENTAL HEALTH 12 Programs should be set in place to provide comprehensive and specialized training of law enforcement agents on how to respond to behavioral health crises. With such training, the officer will be better placed to recognize teenagers who act as a result of mental illness problems. They will recognize the signs and symptoms of mental illness and apply a range of de-escalation and stabilization techniques instead of a force that may worsen the teenagers’ mental crisis (Bureau of Justice Assistance, 2021). This also calls for the development of a curriculum and other resources to use in the comprehensive training. Policymakers can leverage the existing mental Health First Aid for Public Safety to come up with a wider syllabus that covers a broader range of topics to fully equip law enforcers to properly manage teenage mental problems. Policy Recommendation VI: Leverage Information and Communications Technology The government should create and reinforce a multidisciplinary technological innovation team that will develop, prototype, and test an assortment of technology user-interface and userexperience designs for teenagers’ crisis text and hotlines (Academy Health, 2019). Innovations in information technology have permeated all sectors of life and can be leveraged to enhance response to teenage mental health problems. Teens easily identify with ICT. These technologies can be used not only to identify but also to correctly diagnose mental illness through professional assessment and triage (Academy Health, 2019). This will help teenagers get on the path to recovery. As of December 2017, there were 5, 783 primary and secondary public service answering points (also known as 9-1-1) within 3,135 jurisdictions. There were also numerous helplines, the most prominent being the National Suicide Prevention Lifeline. Creating a 3-digit code US TEENAGE MENTAL HEALTH 13 specifically designed for national suicide prevention and mental health response would simplify access to potentially life-saving resources for teenagers who are suicidal. Conclusion The problem of teenage mental illness is wide and complex. There are far too many teenagers who are suffering. The government can no longer afford to bury the head in the sand as the problem is affecting the entire American society. It calls on all members of the American society to come together and take appropriate action in order to avoid the devastating impact of the mental health crisis confronting America today. This policy paper is part of that effort. US TEENAGE MENTAL HEALTH 14 References Academy Health. (2019). Addressing Teen Mental Health Crises: A National Policy Playbook. Academyhealth.org. Retrieved 8 May 2021, from https://academyhealth.org/sites/default/files/addressingteenmentalhealthcrisesplaybook_s ept2019_final.pdf. Bureau of Justice Assistance. (2021). Police Mental Health Collaboration Toolkit. Bureau of Justice Assistance. Retrieved 8 May 2021, from https://bja.ojp.gov/program/pmhc/training. Child Mind Institute. (2020). 2020 Children's Mental Health Report: Telehealth in an Increasingly Virtual World. Child Mind Institute. Retrieved 28 April 2021, from https://childmind.org/our-impact/childrens-mental-health-report/2020-childrens-mental- health-report/. Cooper, J. L., & Aratani, Y. (2015). Children's mental health policies in the United States: perspectives from advocates and state leaders. Health Expectations, 18(6), 2213-2222. Curran, H. (2018). Facilitating Collaboration Among School and Community Providers in Children's Mental Health. Scholarworks.waldenu.edu. Retrieved 8 May 2021, from https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=5537&context=dissertation s. Hertz MF, Barrios LC. Adolescent mental health, COVID-19, and the value of schoolcommunity partnerships. Inj Prev. 2021;27(1):85-86. doi:10.1136/injuryprev-2020044050 US TEENAGE MENTAL HEALTH 15 Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., Brigden, A., ... & Crawley, E. (2020). Rapid systematic review: the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID19. Journal of the American Academy of Child & Adolescent Psychiatry. Major depression. National Institute of Mental Health. Updated February 2019. Accessed online February 7, 2021. https://www.nimh.nih.gov/health/statistics/major-depression.shtml Mental Health America. (2021). The State of Mental Health in America. Mental Health America. Retrieved 28 April 2021, from https://www.mhanational.org/issues/state-mental-healthamerica. Moon, J., Williford, A., & Mendenhall, A. (2017). Educators' perceptions of youth mental health: Implications for training and the promotion of mental health services in schools. Children and youth services review, 73, 384-391. National Institute of Mental Health. (2021). NIMH » Child and Adolescent Mental Health. Nimh.nih.gov. Retrieved 8 May 2021, from https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/. National Institute of Mental Health. (2021). NIMH » Mental Illness. Nimh.nih.gov. Retrieved 28 April 2021, from https://www.nimh.nih.gov/health/statistics/mental-illness.shtml. Policy Paper (1) Criteria Ratings Pts Introduction to Paper 1. Introductory paragraph laid out the format and direction of the entire paper 2. Clearly states the topic studied/explored in the paper 3. All key terms are defined 4. Briefly discusses the importance of the topic within the context of child and adolescent development 10 pts Current State of Affairs 20 pts 1. Reviews the present state of affairs on the topic-including current key statistics from highly credible sources 2. Reviews current policies and/or laws that are related to the topic Deficiencies in Current Policy 1. Discusses the problems with the current situation 2. Reviews related research and theory in child/adolescent development that supports the shortcomings of the current policy using scholarly/peer reviewed journals 25 pts Statement of Policy Suggestions 1. Presents and discusses credible ideas on how to address the problem 2. Shows a specific connection between policy suggestions and the research and theory that was reviewed 3. The research and theory clearly provides the evidence that the policy suggestions will be more likely to produce positive outcomes than have the current/existing policies 15 pts Overall Quality of Paper 1. The topic is thoughtfully and fully developed 2. Writing is clear and paper is well organization 3. Quality of syntax and grammar is consistent with standard expectations in a senior/capstone course 4. Quality of discussion posting and response 25 pts APA Format 5 pts 1. Overall organization of the paper meets requirements of APA 2. In-text references, numbers, headings, spacing, etc. are all correctly formatted 3. Reference section is properly formatted Total Points: 100 ?Xnip ?? Topic Ideas The following list represents just a few of the general topic areas that could be developed into a 10- to 12-page policy paper for this class. I encourage you to explore topics beyond this brief list and to select one that is truly meaningful to you. Please do not forget that you must have your topic approved or you will not receive credit for your paper. You may not write on a topic or use readings that we have covered in our seminars. . . Children's health care programs Mental health programs Child care School intervention programs for young children Children's health insurance National standards for teachers Family leave Sexual abuse of children or teens Maternal drug use • Welfare reform Bullying Dental health Food assistance programs for children Developmental assistance programs for children with autism Violence at school • Foster care . . . . Note: All policies should be either for the US as a whole or specific to California. Format and Points for the Policy Paper = 100 Points Total (Note that this is an outline for your paper--be sure to use the terms in blue in your paper as headings) Introduction to Paper (10 Points) [paper title = heading for this section; there is no heading called "Introduction" in APA format] . Begin with an introductory paragraph that lays out the format and direction of the entire paper Statement of topic studied Define any key concepts Briefly discuss the importance of the topic within the context of child development . Current State of Affairs (20 Points) O Review the present state of affairs on your topic-include any key statistics (be sure to use as current as possible sources for this; also be sure they are highly credible sources). Review any current policies and/or laws that are related to your topic . Deficiencies in Current Policy (25 Points) Discuss the problems with the current situation • Review related research (look at actual research reports rather than literature reviews of research) and theory in child development that supports your view of the shortcomings of the current policy (you must you scholarly/peer reviewed journals for this) Statement of Policy Suggestions (15 Points) . Present and discuss your ideas on how we should address the problem--You can list them in a numerical format for clarity if you like • Be sure to show a specific connection between your policy suggestions and the research and theory that you have reviewed. The research and theory should provide the evidence that your ideas will be more likely to produce positive outcomes than have the current policies APA Format (5 Points) • Overall organization of the paper (be sure to include an abstract) • In-text references, numbers, headings, spacing, etc. • Format the reference section Overall Quality of Paper (25 Points) . . Importance of topic Extent to which the topic was developed Clarity of writing and degree of organization Quality of syntax and grammar . . Exam Information Final Essay Exam (I will post in "Assignments" on 5/17 @ 9A due 5/21 @11:59P) 1. Students will also submit a (~250-300 word) response to a Final Exam question posted by the instructor through the Assignments function on Canvas. 2. The response to the instructor's question should reflect the requirements listed in the question as well as a focus on; a) the readings-your ideas and comments must bring in the research, statistics, and concepts of any related articles; b) a quality of thought and understanding of the information covered this term that is consistent with your senior status; C) proper grammar, syntax, and spelling. (Also in APA format!)