Advocating for Children’s Behavioral Health in Boston and Beyond
Boston Children’s Hospital has a long-standing commitment to children’s behavioral health.
The hospital is focused on increasing access to care, expanding resources, and improving public policy both locally and nationally. “There’s more awareness today and improvements have been made, but there’s more to do,” says Josh Greenberg, vice president for Government Relations at Boston Children’s.
Clinicians can play a vital role in informing legislators about needed policy changes by sharing their experiences.
“We help bring the issues to life,” says Dr. David R. DeMaso, psychiatrist-in-chief at Boston Children’s. “We share examples of how policy affects children and their families and shed light on how legislative and regulatory changes could improve outcomes for children.”
Campaigning for change
The Children’s Mental Health Campaign (CMHC) is a coalition of families, advocates, health care providers, educators, and consumers from across Massachusetts. Together, they advocate for children to have access to resources that prevent, diagnose, and treat behavioral health issues.
The campaign was created after the Massachusetts Society for the Prevention of Cruelty to Children asked Greenberg and DeMaso if Boston Children’s would partner to write a whitepaper examining the state’s children’s mental health system.
The hospital agreed, but only if they also developed companion legislation, launched the campaign, found the right partners and worked to change policy.
That’s exactly what they did.
The 2006 whitepaper led to legislation being passed and a broader coalition coming together to form the CMHC. Boston Children’s committed to raising money to fund the campaign for the first five years.
The campaign also worked to reduce the practice of pediatric behavioral health boarding (where patients are held in the emergency department or medical unit until an inpatient bed becomes available in a psychiatric facility).
Working with campaign partner Health Law Advocates, Boston Children’s helped create a program in family resource centers to provide legal assistance to ensure a child with behavioral health needs gets access to health and education services.
Today, the campaign continues to promote and advocate for a comprehensive and coordinated system that is accessible to all children and families.
Boston Children’s also has made advances by integrating behavioral health services into primary care settings with a program that places licensed clinical social workers in pediatrician offices. Psychiatrists are available to consult with the social workers to determine whether a child requires referral to a psychiatrist.
“There is evidence about the benefits of behavioral health screenings for young children," says Greenberg. “We have an opportunity to help address behavioral health issues early on and avoid more acute problems later on in a child’s life.”
Schools are another key to access.
The CMHC recently received a grant from the C.F. Adams Charitable Trust to develop a policy and advocacy agenda to ensure that children in schools are getting access to prevention and intervention. Boston Children's Hospital Neighborhood Partnerships Program, which has been a leader in providing school-based and community efforts for more than a decade, is helping to develop the advocacy agenda.
CMHC helps ensure that when a policy is being made — the concerns of children are at the forefront.
“We have seen progress in how our public policy has been able to address the behavioral health needs of kids,” says Greenberg.
For example, it’s been a challenge for families to find mental health clinicians through insurance providers’ directories as information was not regularly updated. Massachusetts recently passed legislation requiring insurers and providers to work together on the directories and ensure that in-network providers and specialists are listed accurately.
Boston Children’s and its partners are involved in other policy issues, such as mental health parity, which requires that mental health conditions and substance use disorders are treated the same as physical health conditions. Members of the CMHC were proud to stand with the Massachusetts State Senate in February 2020 as it approved the Mental Health ABC Act, which could lead to significant changes in the system.
Greenberg says there is still much to do.
“You can’t take your foot off the gas pedal because if you do, people will stop paying attention,” says Greenberg, “So we keep pushing.”