During the 2018-2019 school year, nearly 80,000 Georgia students in sixth through 12th grade considered attempting suicide, according to the School-Based Mental Health report. The report also finds that nearly 40% of children have trouble accessing the mental health treatment they need. Undoubtedly, greater access to mental health resources at schools would be beneficial for Georgia students.
Georgia currently ranks 51st in children’s mental health services, meaning it has a high prevalence of mental illness and lower rate of access to care. This is a particularly low ranking considering efforts to increase funding for child mental health. In 2018, Governor Deal and the state legislature included an additional $21.4 million in the FY 2019 state budget to improve and expand children’s behavioral and mental health services. $4.3 million of those funds are dedicated to the Georgia Apex program.
The Georgia Apex Program, established in 2015 by the Department of Behavioral Health and Developmental Disabilities, is a school-based mental health pilot to increase the availability of mental health services in Georgia elementary and middle schools.
Nearly one in ten Georgia children ages 2 to 17 years have one or more diagnosed emotional, behavioral, or developmental conditions. These conditions can inhibit a child’s ability to learn and be successful in the classroom. While Georgia’s child mental health resources at schools have improved over the last few years, the pathway that the Apex pilot program has created, provides an opportunity to expand the services by Georgia policymakers.
The Apex program has the potential to receive more grants to fund clinician’s school-based work. School-based mental health programs can be staffed with licensed and associate-level clinicians on-site. Currently, they are funded via a combination of insurance (usually Medicaid or PeachCare for Kids) and private and government grants.
While the APEX Program and School-Based Mental Health Program have created positive outcomes for students across Georgia, the impact could be greater with increasing funding for these programs. According to The Georgia Apex Annual Evaluation Report, the quality of staffing and patient outcomes could be improved with more funding from the state government.
There are numerous barriers for sustaining child mental health programs in Georgia public schools. Currently, there are not enough providers in schools across the state to meet the need for the services of the programs. Across Georgia, 47% of counties do not have a licensed psychologist and 33% of counties do not have a licensed social worker at all. Children who seek mental health services via the programs in school are referred to a clinician who provides an assessment and treatment after obtaining consent from the student’s parent. Additionally, providers can conduct home visits, provide crisis support and manage medication as part of their treatment. However, there is a provider shortage for these schools. There needs to be increased funding for school-based mental health programs in order to employ more providers. Salary constraints and workforce shortage have also made it difficult to employ providers.
Even if a school has a successful mental health clinician program available, the child may not have the insurance to seek services. Georgia has a high rate of uninsured children, most of who are eligible for Medicaid or PeachCare.
Georgia policymakers have suggested streamlining Medicaid eligibility determination policy and practices to reduce the number of uninsured children, reducing the administrative burden of insurance billing and making medical necessity determinations more transparent and consistent. However, little has been done to implement these suggestions.
As of June 2018, the Apex Program was in 55% of Georgia counties and 56% of Georgia school districts. Over the program’s first three years (August 2015 to June 2018), 8,705 students were served who had not previously received mental health services. Overall, access to mental health services increased and progress is being made towards prevention and early detection of mental health needs in youth.