I had a tele-medicine appointment scheduled with a patient of mine, who was in the Emergency Room the night before for chest pain. My patient was an otherwise healthy 11-year old male. All of his exams were normal and fortunately he tested negative for COVID-19. I shared these results with him and his mother during the appointment. But what explained his chest pain?
I learned that he had been experiencing chest pain sporadically for the past several months, a tell-tale sign of anxiety. His mother wanted him to see a therapist. But like 4 million other children in this country, he doesn’t have insurance right now, and she cannot afford to pay out of pocket for treatment. My patient is just one of many Americans who are struggling with the mental health impacts of the COVID-19 pandemic, but cannot get the help he desperately needs.
It is clear that the pandemic is affecting the physical, financial, and mental well-being of our nation. While physical aspects are more easily discernible, effects on mental health may not be apparent right away and will challenge many people over the years to come. Childhood and adolescence are dynamic times with physical and mental changes, both of which are influenced by the environments and people that surround us. Mental health disorders are prevalent in youth, yet we now face a critical shortage in mental health providers and there is limited access to their care. This pandemic will increase the need for their services, thereby further worsening these access issues.
Asian American and Pacific Islander youth, including in the South Asian community, have higher rates of anxiety and depression compared to their peers. In addition, while accidents are the leading cause of death for youth between the ages of 12 and 19 in America, suicide is the leading cause of death for AAPI individuals of that age group. At a time when mental health services are needed more than ever, this issue still lacks the appropriate attention in terms of both funding and intervention. There is still a stigma associated with mental health disorders amongst many communities, especially the South Asian community.
In the face of this youth mental health crisis, President Trump has proposed draconian budget cuts to mental health programs. His 2021 budget makes significant cuts to Medicaid, the largest payer of behavioral health services, slashing funds by $920 billion over the next 10 years. President Trump’s policy decisions will only worsen mental healthcare delivery in this country. In addition, proposed budget cuts to health and science agencies such as the NIH will hinder future research for mental health disorders and treatments. Despite numerous tragic mass shootings in recent years, and widespread acknowledgment of the role of mental health illness as a root cause of so many of these tragedies, this administration has done little to address prevention and treatment of mental health disorders.
Vice President Joe Biden recognizes the need for reform when it comes to mental health services. First, he understands that mental health is just as important as our physical health. During his time in office, Biden hosted the National Conference on Mental Health at the White House to raise awareness of the importance of this issue and of the need to integrate behavioral health services in the pediatric primary care setting. Second, he understands the importance of funding for these programs and increasing access and resources for our youth. He has championed efforts to increase funds and access to services and promises to continue to do so while also enhancing the services already in place. Lastly, Biden recognizes the link between health and academics and the key role schools play in our children’s health. His comprehensive education plan includes significant investment in school mental health professionals, which will increase access to psychologists, guidance counselors, nurses, social workers, and other health professionals.
Vice President Biden has expressed, and continues to express, his dedication to this important matter, and will work towards eliminating the stigma associated with mental health illnesses. He recognizes that dealing with our youth mental health crisis is critical to a healthier and happier future for our youth. The pandemic has made 2020 a truly difficult year, but our vote in November will impact our children for years to come.
(Dr. Mansi Kotwal is an Indian American physician at the Children's National Medical Center in Washington, D.C., and is a Clinical Assistant Professor at the George Washington University School of Medicine and Health Sciences.)