With Florida facing a youth mental health crisis, outdated Medicaid reimbursement policies are leaving schools struggling to meet growing demands, despite opportunities to utilize federal funding to expand services.

Karen Thomas, Medicaid coordinator for Leon County Schools, advocated for significant changes to how mental health services are funded in schools. Recognizing schools are often a trusted resource where students are more likely to seek help, Thomas called for a funding model for mental health services similar to Medicaid's support for school nurses, ensuring schools can effectively address students' needs.

"Bring that funding source up to date," Thomas urged. "Draw down those additional funds and to change the thinking of the state Medicaid agency to help them align with what the federal government supports which is paying for those mental health services at school because that ultimately helps to make kids healthier, more productive."

Currently, Florida schools are reimbursed for mental health services using outdated data from 1997. Thomas argued it is a mismatch between what schools are reimbursed and the real cost of services today. Florida's School Mental Health Report Card showed more than two-thirds of children with major depression did not receive treatment in 2022.

Angela Kimball, chief advocacy officer for the mental health advocacy organization Inseparable, emphasized school-based mental health programs are among the most effective.

"Research is showing that youths who can get school-based services are six times more likely to complete a full course of treatment than with community-based treatment," Kimball reported.

According to the Mental Health Report Card, the state's ratio of one school counselor for every 459 students falls far below the recommended 1:250 standard, creating significant barriers to access.

According to Inseparable, half of youths aged 12-17 with depression are not receiving the treatment they need. Cost, transportation challenges, lack of providers, insurance barriers and stigma influence the gap.

After a legislative session which opened doors to expand mental health care services across Montana, a state commission said it is considering the Billings area to build the state's second forensic facility.

For people involved in Montana's justice system whom a judge has deemed not mentally fit for their own defense, there are 53 beds in the state's only forensic facility in Galen. The daily waitlist hovers at about 100 people.

Matt Kuntz, executive director of the National Alliance on Mental Illness-Montana, said it is not meeting the immense need.

"It's just a really bad situation for the people that are in the jails, for the people that are caring for them, for the taxpayers," Kuntz outlined. "It just doesn't work for anybody."

At a recent commission meeting, Montana Department of Public Health and Human Services Director Charlie Brereton said the state is identifying a location for a new facility. The department received nearly $27 million from the state in April to fund project planning.

Kuntz noted the Montana Legislature passed many bills this session centered on mental health care.

"We really were able to get big wins in access to outpatient care, access to crisis care and for people in need of forensic hospital," Kuntz explained. "Overall, it was really an amazing legislative session for Montanans with mental health conditions."

Other mental health legislation will boost school-based services, youth in residential care, the state's 988 crisis line and certified community behavioral health clinics.


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The California Parent and Youth Helpline is in serious jeopardy after Gov. Gavin Newsom cut it from the new state budget, saying the money was needed to support medical services.

Advocates said they are puzzled because the governor has championed the helpline for years, and lawmakers approved $3 million from a separate fund dedicated to mental health, which does not affect the deficit.

Lisa Pion-Berlin, president and CEO of the nonprofit Parents Anonymous, which runs the helpline, said it is still operating 24/7, for now.

"We're holding on for the next month or so," Pion-Berlin pointed out. "But we need the state to step up, or one of these well-off philanthropists who cares about having that immediate help for emotional support, which is so vital."

Advocates are hoping funding can be restored via a budget trailer bill in the next few weeks. People can call or text and reach the helpline's trained counselors at 877-427-2736. The free helpline has connected with more than 120,000 people since its inception five years ago, and the website CAParentYouthHelpline.org has reached a million more.

Pion-Berlin noted a study in the Journal of Technology in Human Services found a call to the helpline can quickly ease parents' suffering and feelings of isolation.

"The research said that 85% of the callers in less than 30 minutes feel more positive, more hopeful and able to address their issues," Pion-Berlin reported. "There is no other service or pill I know that can do that in 30 minutes or less."

Parents Anonymous also offers free weekly support groups to steer parents and kids through emotional crises of all kinds.

Minnesota teens are using their summer break to set aside added stress and anxiety they deal with during school and as the age group gets more attention for its mental health needs, parents of younger kids are urged not to miss warning signs.

The Minnesota chapter of the American Academy of Pediatrics hosted a discussion coinciding with the start of summer. As parents spend more time with their kids over the next few months, health professionals said persistent behavioral issues among preschool age children should not completely be written off as phases.

Dr. Helen Egger, a child psychiatrist, said key data is consistent with other age groups.

"The rate of impairing mental health disorders in preschool children, here we're talking about children 2-5, is actually the same as the rate in older children and adults," Egger explained.

The Centers for Disease Control and Prevention has noted the number of adolescents reporting poor mental health is increasing. For younger kids, Egger pointed out pediatricians and parents need to be mindful of things like excessive tantrums or trouble eating and sleeping. She warned there is a misconception kids are resilient and those problems will fade away.

Egger added there is a connection between parental stress and behavioral issues in young children. She recommended parents take an active role in family therapy interventions to benefit the whole household.

"Sixty percent of the families who, when they started therapy, said that they had an unmanageable level of stress," Egger noted. "For 60% after 12 or more sessions, they were at a manageable level of stress."

Egger emphasized Minnesota has strong resources for parents to turn to when figuring out the appropriate interventions. She pointed to the website for the Minnesota Association for Children's Mental Health as a key option.


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