NEW BEDFORD — As the new school year begins, a critical shortage of mental health care professionals in Massachusetts is more severely affecting children, according to local providers and health organizations.
The challenges of providing care to children — from a maze of paperwork to difficulties with scheduling and transportation — have exacerbated an already significant shortfall: only 41% of the total need for mental health services could be met in Massachusetts, according to a July report from the U.S. Department of Health and Human Services.
“For kids it’s a terrible crisis,” said Anthony Gallo, a psychiatrist whose practice has expanded telehealth counseling in New Bedford.
A clinical psychologist based in New Bedford, Matthew Goodman, said: “More people are calling looking for a therapist, and I don’t have the availability” among 32 weekly appointments. He also said it’s harder to make referrals. “Everyone is booked up. That’s a new phenomenon, and that feels different,” he said.
Increased demand during the pandemic has not subsided for the fourth first-day-of-school since its onset. Schools have responded by increasing the number of in-house counselors and partnering with more community health organizations.
“We’ve probably doubled our counseling capacity” over a number of years, said Kathleen Mackenzie, supervisor of behavioral health for New Bedford Public Schools. She said that every school has “at least one” counselor, for a total of 60 providers employed by the district.
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Meanwhile, Child and Family Services, the nonprofit health organization, has partnered with the district to provide clinical services inside 10 elementary schools and all three middle schools. (The group also partners with Acushnet, Fairhaven, Old Rochester Regional, and New Bedford’s Voc-Tech districts.)
“We see a major spike in services at the start of every school year,” said Chanda Coutinho, an administrator at Child and Family Services. That mostly has to do with kids returning to classrooms with adults who notice their struggles, she said, but there are also predictable spikes near holidays and report cards.
Coutinho agreed there are challenges to providing children with appropriate care, and said dealing with parents is key. “You can’t just start services with a kid. You have to really make sure their parent is on board and has authorized treatment,” she said. “Some parents don’t want treatment.”
However, Child and Family Services has opened a new community behavioral health center on Church Street that has made it an outlier: “Right now we don’t have a wait for kids — or anyone — who wants to come in for therapy,” Coutinho said. “I’ve worked here for 21 years and that’s never been the case.”
The new facility offers a mix of outpatient, inpatient, and crisis care services that are open 24/7. “You’re not going to be turned away,” said Pam Bolarinho, another administrator.
Demand is still high; with more than 250 scheduled behavioral health appointments each week, at least 60 unscheduled walk-ins, and more than 20 total inpatient beds, the new center has been busy. There’s also a call center receiving between 400 and 700 calls every day.
While offering a tour of the youth crisis stabilization program, a nine-bed inpatient center for minors, Bolarinho remarked, “When school starts, all these beds will be filled.”
Not only is it often harder to care for children, but recent research suggests that young people are suffering negative mental health consequences caused by the pandemic at higher rates than older cohorts, according to the Kaiser Family Foundation.
Across all ages studied, younger groups said that feelings of worry and stress were more negatively influencing their lives. The research also found that mental health concerns were worse for women, in particular for mothers, than for men.
The study’s authors attribute these trends to school closures and lack of child care during the pandemic, which had disproportionate and lasting effects on the lives of young people and the women who were more likely to care for them.
And while school closures were capable of degrading the mental health of students and caregivers, their proper functioning also offers “a unique position to identify students who may be in need of emotional support,” according to a statement from Child and Family Services.
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To cover the cost of the counselors and health partnerships it provides, New Bedford Public Schools will expend more than $7.2 million on behavioral health services this year, according to internal projections, which is a rate of over $39,000 each day.
But without the district providing services, private practitioners are not in a position to pick up the slack.
Gallo, the psychiatrist offering remote counseling in New Bedford, explained that providers aren’t incentivized to see more children, especially when there’s a shortage for adults, too. The extra paperwork for children, he said, “adds an extraordinary time demand onto the provider … but you’re not getting paid more for that coordination of care.”
And Goodman, the local psychologist, said that the proliferation of computer-based care could help, but it isn’t always a desirable alternative for in-person treatment. “When you work with kids, remote therapy is really hard,” he said. “If they wander off you’re limited in what you can do.”
Starting on Aug. 31, when all New Bedford schools were back in session, school-based counselors, including those provided by Child and Family Services, restarted the annual process of identifying kids in need.
It’s important to be in the schools, Coutinho said, because, “We have to understand kids and speak their language.”
Email Colin Hogan at chogan@newbedfordlight.org
Providing adequate mental health care is also a problem for underprivileged. This leads to adults being unable to work, lower quality of life, premature death, and sometimes violence. And it’s just plain stupid. Public money that should have paid for mental health is instead spent on physical health care, imprisonment (isn’t the average $30,000 a year or more?), and the effects of violence including mass shootings. I say these things after many years of seeing my adult daughter go through it only to suffer a premature death.
Let’s see, my mom and dad have been on and off crack and alcohol for most of my life so it’s not my fault I’m screwed up. Where do we start? I love how Governor Weld shut down State Hospitals and integrated all the clients into neighborhood homes with fragmented, inconsistent support. Ahhh, not too many on the Vineyard or Nantucket! Maybe they could build some there through eminent domain.