EXPERT BIO: David Rubin, MD, MSCE, co-director of PolicyLab at The Children’s Hospital of Philadelphia, is available for interviews to comment on how recent scientific evidence is being borne out in real-world current events, illustrating a clear need for improving mental health care access and delivery in the US.
Dr. Rubin is a practicing pediatrician and nationally-respected children’s health policy researcher whose recent work has included two peer-revewed publications on the use of powerful psychotropic medications among youth on Medicaid (particularly youth in foster care) and a recent editorial published in the JAMA Pediatrics which examined mental health infrastructure for American children and families’ ability to access appropriate mental health support.
The research conducted by Dr. Rubin and his colleagues at PolicyLab has provided crucial data being used to reform systems of child abuse reporting, evaluate and address the use of prescription antipsychotics among children in foster care, implement standardized developmental screening in pediatric primary care offices, and improve public programs to support for at-risk parents.
In the JAMA Pediatrics editorial, Dr. Rubin uses two studies on the prevalence of psychotropic medication use among US children to illustrate the barriers families face to accessing adequate mental health services, regardless of their income level or insurance status. Many children do not have access to the appropriate services they need, and rates of medication use (whether high or low), ineffective youth suicide prevention measures, and troubled youth who slip through the cracks and commit acts of public violence are really symptoms of “a mental health system that does not meet the standard of what any parent--whether rich or poor-- would hope for their children if they were in crisis."
JAMA Pediatrics Editorial: http://archpedi.jamanetwork.com/article.aspx?articleid=1465771
WHY NOW: Within the space of a month, issues surrounding mental health support and safety nets for young Americans have been prominent on the national stage. At the same time the Sandy Hook shooting raised the consciousness of Americans to untreated mental health needs for children, a Government Accountability Office (GAO) report was released finding that 65-69 percent of children who had a potential need for mental health services did not receive them, regardless of whether children were publicly insured by Medicaid or were covered by their parents’ private insurance policies.
GAO Report: http://www.gao.gov/products/GAO-13-15
Last week, a study in JAMA Psychiatry found inadequate support for teens considering suicide: 55 percent of teenagers who plan or attempt suicide had already received some therapy before they thought about suicide, planned it, or attempted it. Very few received those services in close proximity to their actual plan or their attempt. The findings raise questions about the effectiveness of current approaches to helping troubled teenagers. According to the New York Times, The JAMA study ” is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference.”