House Subcommittee Holds Hearing on Mental Health Issues

WASHINGTON — The House Energy and Commerce Subcommittee on Oversight and Investigations held a meeting on Feb. 17 to discuss efforts to address the mental health needs of Americans, particularly children, after data collected during the pandemic revealed sharp increases in emergency room visits involving youth self-harm and suicides. 

“Children are in dire need of mental health support. … [They] are susceptible to mental health challenges posed by an increased reliance on social media, and many of our children are only just recovering from spending much of the last two years away from classrooms,” said Rep. Tom O’ Halleran, D-Ariz., during a recent hearing held by the subcommittee.

In 2020, mental health emergency department visits rose by 24% or more for children aged 5-17, according to research from the Centers for Disease Control and Prevention.

There was a disproportionate impact seen among Black children under age 13, who were nearly twice as likely to die by suicide as White children, according to research published in JAMA Pediatrics. 

Recent estimates also suggest that adolescents spend an average of seven hours a day on their phones. Now, additional research is surfacing which may link the rise in emergency department visits during the pandemic to children spending more time online on social media and digital platforms. 

“These co-occurring trends — of increasing digital media use and rising mental health diagnoses — have led to concerns about a potential link. Is social media use causing mental health problems? Unfortunately, the current state of the research does not provide a simple, definitive answer,” said Jacqueline Nesi, assistant professor of psychiatry and human behavior at Brown University, during the hearing.

Nesi recently completed a study of almost 600 psychiatrically-hospitalized youth finding that more than one quarter had viewed content, such as posts or photos from peers, related to self-injury or suicide on social media.

“In extreme cases, youth may even encounter messaging that encourages suicide or self-harm,” said Nesi.

Research also shows that even prior to the pandemic, only 13.6% of U.S. children aged 5-17 had received mental health treatment in 2019. 

In 2021, a law was introduced to strengthen the Departments of Labor, Treasury, and Health and Human Services with new enforcement tools to strengthen coverage of mental health and substance use disorders through the Consolidated Appropriations Act of 2021.

The act requires insurance companies to submit analyses of their coverage of mental health and substance use disorder benefits to the three departments. 

“Unfortunately, their first report, just recently released, found that insurance companies are failing to deliver parity for mental health and substance use disorder benefits, and are falling short of their obligations under the law,” said Rep. Frank Pallone, Jr., D-N.J., chairman of the House Energy and Commerce Committee, during the hearing.

According to Pallone, a number of mental health resources are set to expire in September, which is why the committee met to try to reauthorize a wide range of Substance Abuse and Mental Health Services Administration programs. 

Through the fiscal year 2021 funding bill, the CARES Act, and the American Rescue Plan, Congress provided $9 billion to states, tribes, and localities to respond to mental and behavioral health needs. 

Pallone helped to shepherd the Mental Health Parity and Addiction Equity Act, and expanded the parity to individual market plans in the Affordable Care Act.

Last year, the House passed nine additional bills to support the mental health needs of health care providers and students and address inequities in services. The National Suicide Prevention Lifeline and its new 988 dialing code will also launch this summer. 

In recent federal efforts, the COVID-19 Mental Health Research Act was introduced by members of Congress last year to fund research to study the effects of the pandemic on the mental health of Americans, including children and providers. 

Out of all the recent federal efforts aimed at preventing youth in crisis, there are only two bills that have been recently introduced in the House and Senate that specifically aim to tackle the growing mental health crisis of youth through schools. 

The Youth Mental Health and Suicide Prevention Act introduced by Sens. Jacky Rosen, D-Nev., and Lisa Murkowski, R-Alaska, would authorize the Substance Abuse and Mental Health Services Administration to provide funding assistance to school districts for comprehensive student mental health promotion and suicide prevention efforts.

The bill would provide SAMHSA with a grant that would support training programs for students and school staff for responding to student mental health issues, and utilize social media applications and telehealth to conduct suicide risk and mental health screenings.

Similar legislation was introduced by Reps. Tony Cárdenas, D-Calif., and Lori Trahan, D-Mass., and included in the Cárdenas Health Equity Access, Resources, and Treatment Package — a health equity legislative package that was released last year.

“I think the key thing is mandating and standardizing and funding K-12 suicide prevention curriculum,” said Christopher Thomas, co-founder of The Defensive Line, a non-profit foundation focused on preventing youth suicides, especially among youth of color, during the hearing. 

Thomas started the non-profit in May 2020 after his own daughter died by suicide. He began working with teachers and coaches to identify and address signs of youth in crisis in schools in Dallas, Texas and Las Vegas, Nevada.

He does this by using mnemonic devices like D-Lines: Don’t ignore your gut, Listen for the signs, Interact, Name the concern, Evidence the concern, and provide a Supportive environment.

“Evidence-based programming in schools that is sort of mandated, as well as funded, would definitely help the students, and in particular students of color,” said Thomas.

Alexa can be reached at [email protected].