Mental health care plunged during pandemic, especially for kids. New Virginia initiative aims to boost access.

Since the start of the COVID-19 crisis, experts have warned of a coming mental health epidemic in tandem with the virus’ physical threat.

Extended periods of social isolation, mixed with grief and well-founded worries about the future, were bound to prompt mental health conditions for some and worsen others, they said.

More than a year later, three times as many Virginians reported serious mental health symptoms than before the coronavirus, according to a recent study from Eastern Virginia Medical School.

But there hasn’t been a corresponding jump in people receiving mental health services, some health officials and insurers say. The gap is especially wide among children.

A new Virginia program, in the works for several years but launched with renewed vigor during the pandemic, is hoping to boost access for kids who need mental health care. A lot of pediatric mental and behavioral health referrals come from the school system, officials say, so school closures have limited options for kids.

More than 35% of children who receive such treatment do so exclusively at school, according to an article last year in the Journal of the American Medical Association Pediatrics edition.

“Schools have long served as a de facto mental health system for many children and adolescents,” the authors wrote.

It’s harder to notice a child’s issues with attention deficit, for example, over Zoom, said Dr. Sandy Chung, a pediatrician in northern Virginia who’s the immediate past president of the American Academy of Pediatrics.

But the pandemic has heightened a need that was already there, she said. The Virginia Mental Health Access Program, officially launched last week, was created with that in mind.

In recent years, Chung struggled to find psychiatrists for her patients. In one tragic case, a 14-year-old boy with bipolar disorder came to her practice looking for medication refills. Because they were complicated prescriptions she didn’t normally handle, she booked him an appointment with a child psychiatrist. But while waiting for the appointment, he ran out of his medication. With the disease not under control, he shot and killed someone and ended up in jail, Chung said.

She looked into the issue of long wait times for children and discovered Virginia ranks in the bottom 10 states for the availability of its behavioral health provider workforce, according to one prominent national report.

Chung is now medical director for the new mental health access program, which trains doctors around the state to directly provide critical mental and behavioral health care to children with immediate needs, rather than sending them to psychiatrists with long waiting lists.

“The concept is we would rather refer but we can’t because there’s not enough mental health providers,” Chung said. “Because of that wait we have families who are suffering.”

Even a $224 million new psychiatric center the Children’s Hospital of The King’s Daughters plans to open in Norfolk, for example, won’t be able to keep up with demand on its own, she said.

The access program’s training starts with a weekend or webinar and continues over about six months, Chung said. There’s also a consultation line that doctors can call at any time for help staffed with behavioral health providers and social workers, and officials plan to help connect patient families with resources to navigate the mental health system.

Virginia has about $7 million annually for the program moving forward, Chung said. They hope to expand to adults but would need more funding at some point.

In Virginia last year, health insurer Anthem found a sharp drop-off in mental health diagnoses for children. About 14% fewer young children and 8% fewer adolescents were treated for mental health diagnoses compared to the year before, according to a mental health report Anthem commissioned.

Dr. Anne Fedyszen, medical director for behavioral health services for Anthem in Virginia, said the insurer saw a drop in specific diagnoses such as ADHD — by 17% in young children — presumably tied to school closures.

“It’s harder to notice in virtual school,” Fedyszen said.

The trend also rings true at Medicaid, the publicly funded health insurance program for people with low income, according to the Centers for Medicare & Medicaid Services.

Mental health services used by children under 19 through Medicaid and its Children’s Health Insurance Program dropped by over a third compared to 2019, the agency said in an email.

As a pediatrician, Chung said, “I am concerned about long-lasting effects in children. We’ll be dealing with this for decades to come.”

Katherine Hafner, 757-222-5208, katherine.hafner@pilotonline.com