The Medicaid program provides coverage to 27 million children under age 18 in the United States. According to the U.S. Surgeon General, while 11 percent of youth have been diagnosed with a mental illness, two-thirds of youth who have a condition are not identified and do not receive mental health service. Research by the National Institute on Mental Health found that half of all lifetime cases of mental illness or substance use begin by age 14. Recent information regarding mental health and substance use disorder conditions among children indicates:
- The rate of current illicit drug use among all youth (Medicaid and non-Medicaid) aged 12 to 17 is 10.1 percent, 25% higher than individuals age 18 or older.
- Suicide was one of the top 10 causes of death of students in the United States in 2009. Almost 14 percent of these students have seriously considered suicide. Six percent report having attempted suicide one or more times in the past 12 months. The presence of major depression, bipolar disorder and alcohol and drug abuse are frequent risk factors for suicidal behaviors.
- Children exposed to trauma, including maltreatment, family violence, and neglect, exhibit symptoms consistent with individuals diagnosed with post-traumatic stress disorder, attention deficit/hyper-activity disorder, depression, and conduct disorder/oppositional defiant disorder.
CMCS has developed the following resources to provide information regarding services and good practices for children and youth with a behavioral health disorder. CMS is encouraged with the increased interest by states to develop effective strategies for developing benefit designs for this population. Many states have included behavioral health services for these individuals in the State Plans and various Medicaid managed care Waivers.
- Technical Assistance Questions and Answers: Qualified Residential Treatment Programs (QRTP) and Serious Mental Illness (SMI) and Serious Emotional Disturbance (SED) Demonstration Opportunity - September 2019
- CMCS Informational Bulletin: SPA Residential Pediatric Recovery Center – Guidance to States (Section 1007)
- Joint CMCS and SAMHSA Informational Bulletin: Information to States and School Systems on Addressing Mental Health and Substance Use Issues in Schools
- CMCS Informational Bulletin: Prevention and Early Identification of Mental Health and Substance Use Conditions
- Joint CMCS & SAMHSA Informational Bulletin: Coverage of Behavioral Health Services for Children, Youth, and Young Adults with Significant Mental Health Conditions
- CMCS Informational Bulletin: Collaborative Efforts and Technical Assistance Resources to Strengthen the Management of Psychotropic Medications for Vulnerable Populations
- State Medicaid Director Letter: Use of Psychotropic Medications Among Children in Foster Care
- State Medicaid Director Letter: Tri-Agency Letter on Trauma-Informed Treatment
- CMCS Informational Bulletin: Coverage of Behavioral Health Services for Youth with Substance Use Disorders