Page:Access to Mental Health and Substance Use Disorder Services for Children and Pregnant Women in the Children’s Health Insurance Program.pdf/2

Page 2 – State Health Official  Background 


 * a.Importance of Behavioral Health Services for Children and Pregnant Women

Mental health is key to overall health and plays a critical role in the well-being of children and pregnant women. There are unique vulnerabilities and developmental implications when it comes to mental health and substance use disorder conditions in children and pregnant women. Mental health disorders usually first arise in childhood, adolescence or early adulthood. As many as one in six U.S. children between the ages of 6 and 17 has a treatable mental health disorder. In 2018, an estimated 21.2 million people aged 12 or older needed substance use treatment. About 1 in 26 adolescents aged 12 to 17 (3.8 percent), and about 1 in 7 young adults aged 18 to 25 (15.3 percent) needed treatment. Several common mental health conditions impact Medicaid and CHIP children at higher rates than the general child population including conduct disorder, anxiety disorder, depression, autism spectrum disorder, and attention deficit disorder.

With respect to pregnant women, approximately 40 percent experience psychological difficulties during or after pregnancy with 10 to 15 percent being diagnosed with a mental illness. Low income women are more likely to develop some form of depression compared to other mothers, ranging from 40 to 60 percent suffering depressive symptoms. Pregnant women also face challenges with substance use. A history of trauma has been associated with risk of substance use in women. During 1999 through 2014, the national prevalence of opioid use disorders increased 333 percent from 1.5 cases per 1,000 delivery hospitalizations to 6.5, an average annual increase of 0.4 per delivery hospitalizations per year. In 2018, 9.9 percent of pregnant women drank alcohol, 11.6 used tobacco, and 5.4 percent used an illicit substance.

 SUPPORT Act Requirements 

As noted above, section 5022 of the SUPPORT Act requires that child health and pregnancy related assistance “include coverage of mental health services (including behavioral health) necessary to prevent, diagnose, and treat a broad range of mental health symptoms and disorders, including substance use disorders.” This section describes the requirements for all states with separate CHIPs to cover specific behavioral health related screening and preventive services,