State youth behavioral health programs put at risk by House vote – commentary

April 11, 2022 5:50 am
The shadow of a child on a playground swing

“House Bill 1639 falls into the same category as a number of pieces of legislation we have seen in 2022 that focus on parental rights, whether it is in the area of education, health care, or mental health.” (Getty Images)

The American Academy of Pediatricians, the Children’s Hospital Association, and the American Academy of Child and Adolescent Psychiatry have recently stated that children’s mental health is a national emergency. The American Psychological Association added that children’s mental health is in crisis. Yet, in March, the New Hampshire House approved House Bill 1639, relative to the Youth Risk Behavior Survey (YRBS) in schools, over the objections of educators, students, and advocates for children, mental health and community health centers, and substance use disorder providers. 

This legislation will make the annual YRBS an opt-in as opposed to an opt-out, making it harder to collect information and identify trends. It will also mean that New Hampshire could lose a significant amount of funding for direct behavioral health care services for our young people, by limiting access to the data needed to inform policies and programs.

YRBS was developed by the U.S. Centers for Disease Control and Prevention and is purposefully structured as an opt-out program to maximize participation and expand data collection as widely as possible. Studies show the data collected to be valid and reliable, with safeguards in place to discount false answers; and all the data is aggregated before it becomes publicly available, so it cannot be linked to an individual. State health and education officials use this anonymous data to track trends and develop health systems and policies that prevent and address risky and unhealthy behavior by high school students.  

Particularly in the age of COVID, it is essential to recognize any changes in behavioral health patterns in students so that schools, parents, and programs can adjust their strategies to support youth accordingly. The CDC recently completed a nationwide survey of over 7,700 high school students. They found a third stated they experienced stress, anxiety, or depression during the COVID-19 pandemic. Nearly a fifth reported seriously considering suicide. Now, possibly more than ever, we need data to help inform us what is troubling our young people and how to help them. Shifting YRBS to opt-in would significantly decrease participation in the survey, reducing the amount of data collected, and weakening the prevention and treatment programs that rely upon this data. 

NAMI New Hampshire (the National Alliance on Mental Illness), a grassroots nonprofit agency that offers support, education, and advocacy for individuals, families, and communities affected by mental illness and suicide, has used YRBS data to successfully apply for a much-needed Youth Suicide Prevention grant from SAMHSA. 

These funds are distributed to the project partners – community mental health centers, such as Riverbend Community Mental Health in Concord, regional public health networks, community colleges, and other New Hampshire providers – to fund targeted suicide prevention efforts among youth and transition-age adults. YRBS data was critical in leveraging the current 5-year, $3.675 million, grant and in determining the project’s scope.

The proposed measure to make the YRBS an opt-in survey will yield significantly less data, which will ultimately impact New Hampshire’s ability to secure future funds and ensure interventions are appropriately targeted to our most vulnerable youth.

HB 1639 falls into the same category as a number of pieces of legislation we have seen in 2022 that focus on parental rights, whether it is in the area of education, health care, or mental health. Legislators and citizens who are opposed to vaccines, mask mandates, public education, and public health argue that parents know what’s best for their children and that the state – “bureaucrats” in particular – should have no say.

There is no doubt that parents should be the primary voice, but let’s remember, our young people should have a voice, too. They are the ones who are suffering, using substances to manage anxiety, considering hurting themselves, seeing their friends in pain, and, they are the ones participating in “active shooter drills” just in case the rage of a distraught classmate wreaks havoc in their school. They should have a voice to say what it is like to be them.

It is these vulnerable children who will be impacted the most if HB 1639 becomes law and if funding for programs like NAMI’s suicide prevention grants is lost.

The New Hampshire Senate needs to take a hard look at the programs that will disappear if HB 1639 is enacted and question whether it’s worth creating an opt-in that will have the effect of denying New Hampshire funding for behavioral health services. It is disingenuous to bemoan the mental health, substance abuse, opioid, suicide, and domestic violence problems that continue to plague our beautiful state just because an opt-in sounds like “freedom.”

For all kids with untreated behavioral health issues, it is no kind of freedom. They deserve to have a voice; the YRBS is the tool to share their message.  

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Lisa K. Madden
Lisa K. Madden

Lisa K. Madden, MSW, is the president and CEO of Riverbend Community Mental Health Center and the vice president of behavioral health for Concord Hospital.