WASHINGTON, D. C. - An increased demand for child welfare services during the coronavirus pandemic has caused burnout, traumatic stress issues and significant staff shortages for frontline workers at agencies that help protect children from abuse and neglect, the head of an Ohio association for the state’s public children services agencies told the House Ways and Means Committee on Wednesday.
Public Children Services Association of Ohio executive director Angela Sausser told the committee that a recent national study of child protective workers in Ohio showed that 53 percent of caseworkers demonstrated levels of secondary traumatic stress that met the threshold for Post-Traumatic Stress Disorder.
“They have experienced a decade on the front lines witnessing the scourge of the addiction epidemic on top of a high-stress job that requires complex interactions and decisions on a daily basis,” said Sausser, adding that caseworkers often must make dozens of calls to find placements for children with acute needs.
She urged Congress to make federal money available for mental health support for child welfare services staffers, as it has done for health care workers, and to increase federal investments in the future human services workforce and a stronger system of care for children.
Deepa Avula of North Carolina’s Department of Mental Health, Developmental Disabilities and Substance Abuse Services told the committee that the demand for mental health services grew during the coronavirus pandemic while the supply of mental health care services and practitioners who provide them saw sharp declines. Program closures, revenue loss, and staff turnover have continued to plague many behavioral health providers, she said.
“The country is witnessing an unprecedented behavioral health crisis,” said Avula. “Although the reality is quite grim, the good news is that there are effective and efficient treatments available. A comprehensive and coordinated approach to invest in and continue to expand these services is needed. A spectrum of service enhancements across prevention, early intervention, treatment, and recovery support will help to mitigate the negative consequences of the nation’s behavioral health crisis.”
On top of a shortage of mental health service providers, Legal Action Center attorney Deborah Steinberg said Medicare -- which the Ways and Means Committee oversees -- doesn’t provide adequate coverage for mental health issues, including substance abuse disorders, resulting in inadequate or no treatment until conditions become severe enough to require expensive and preventable hospitalizations.
She said people and families with other health insurance also struggle to get the behavioral health care they need, and those with private health insurance are five times more likely to go out of network for mental health and substance use disorder care than for medical care, even though most individuals and families find it difficult to afford non-network behavioral health care.
“We recommend Congress fill in these gaps in Medicare coverage to make treatment comprehensive and equitable so we can not only help millions of Medicare beneficiaries, but we can improve access to substance use disorder and mental health treatment for as many Americans as we can across our healthcare systems,” said Steinberg.
The chairman of the committee, Richard Neal of Massachusetts, said the federal government needs to help build up the capacity of mental health providers to address the diverse needs of the nation’s patients.
“We also need to strengthen care across the entire mental health continuum, making all types of providers more accessible -- not just physicians,” said Neal. “Marriage and family therapists and licensed clinical social workers are two examples of non-physician providers that could make a huge impact in people’s lives and on their health.”
The committee’s top Republican, Kevin Brady of Texas, said improving access to telehealth could help address the challenges. He said that during the first year of the coronavirus pandemic, the national weekly average numbers of telehealth users leaped from 13,000 to 1.7 million.
“We need to make this telehealth access permanent,” said Brady. “We’ve seen it work. It saved countless lives of seniors and those facing dire mental health challenges ... On the heels of a raging pandemic in a terrible recession, we know the mental health crisis is real. I believe we have an opportunity together to fight it, the tools to fight it.”