Vermont mental health services for children doubles in last two decades

Department of Mental Health Commissioner Sarah Squirrell

In the past two decades, the number of young people 18 and under accessing mental health services has doubled. A recent report showed that one in three children in the state experience at least one “adverse childhood experience” before age nine.

The report from Building Bright Futures, a non-profit organization in Vermont that monitors early care, health, and education systems for potential legislative policy improvements, explained that adverse childhood experiences, or ACES, typically involve living in a home that struggles to cover basic needs.

It can be anything from divorce to living with someone who has a substance abuse disorder or mental health challenge. Incarceration of a parent, illness, domestic violence, or even a parent’s death can also be a root cause.

While all of those things can be difficult to manage for any child, Vermont is good at identifying children in need of support, says Department of Mental Health Commissioner Sarah Squirrell.

She noted that in 2017, 61 percent of children in the state received a developmental screening, which is one of the largest factors in ensuring children get the support they need.

This past February at a suicide prevention event at Vermont’s State House, Squirrell spoke about the effects of challenges on kids and their families, particularly when mental health issues result in suicide.

“At any given time, many of us experience challenges in our lives, see our children and loved ones, our families, our friends struggling,” she said. “The weight of these stresses can lead to thoughts of suicide.”

Gina Plasse, MS, a mental health clinician and supervisor at Howard Center in Burlington, a designated mental health provider in Chittenden County, agrees that Vermont does a good job at streamlining the process so families can get access to necessary services.

“There’s a strong level of cooperation. In just the past few years, there’s been a focus to make services as easy as possible,” she said. “In many cases, there is one main number to call if you need help. Your case is assessed and referred to the proper service. No need for families to go to multiple outlets. We’ve even integrated three separate local crisis teams into one.”

According to the National Alliance on Mental Illness, 50 percent of all lifetime mental illnesses develop by age 14 and 75 percent develop by age 24. But teens and young adults with mental health challenges are not getting the treatment they need.

A study published in JAMA Pediatrics last year showed one in seven children have a treatable mental health disorder with only half of them receiving professional care.

Beth Truzansky, Building Bright Future’s deputy director, said additional research shows adults with ACES in childhood have higher rates of chronic illness. A 2018 study published in Boston Medical Center Pediatrics noted the direct connection between ACES and delays in cognitive development and other physical ailments such as asthma, weight gain, recurrent infections, and even sleep disruption.

Those same issues can carry into adulthood and can have other consequences like substance abuse, diabetes, or stroke.

Plasse, who was part of the Early Childhood Mental Health Task Force and worked on the Building Bright Futures report, says it’s a trickle-down issue. If a parent has ACES, they pass it on to their kids. Then it’s just a vicious cycle of adversity in youth leading to chronic illness in adulthood.

“There is a relationship between the number of ACES and the risk of health outcomes,” said Plasse. “As ACES increase, so do the negative outcomes.”