A Post-COVID Crisis: Illinois’ Battle with Children’s Mental Health

By: Morgan Dreher

Edited by: Simon Carr and Jonathan Perkins

The onset of the COVID-19 pandemic posed a major threat to global health, and the lingering effects are manifesting in a particular domain: mental health. These struggles broadly increased with the start of the pandemic, as the American Psychological Association found that anxiety and depression rates were four times higher in US adults from shutdown months compared to pre-Covid times. [1] While mental health is a pervasive concern, a specific area of legislative focus for Illinois government officials is youth mental health. A press-release from Gov. J.B. Pritzker’s office stated that more than one-third of high school students reported poor mental health during the pandemic, [2] and the National Alliance on Mental Illness found that 145,000 Illinoisians ages 12-17 had depression in 2021. [3] In addition, John O’Connor of AP news reported that 44% of children had depressive episodes lasting at least two weeks, and almost half had thought about suicide. [4] Along with the increase of mental health struggles, demands for care have also risen, where Sarah Karp and Kristen Schorchz of Chicago Sun Times reported that mental health related emergency room visits by kids spiked to about 12,000 in 2021, an increase of 3,000 children compared to 2020. [5] Through the aftermath of the pandemic, Illinois’ infrastructure for mental health resources and support has proved insufficient, illuminating the necessity for legislation in this domain. [6]  

The Illinois mental health crisis is largely due to disparate access to mental health care. John O’Connor reported that in Illinois, “80,000 children under age 18 [live] in areas of the state lacking necessary outlets.” [7] Illinois attempted to remedy this concern previously in the Children’s Mental Health Act of 2003 under the Screening, Assessment, and Support Services (SASS) initiative. [8] SASS was intended to provide more equitable access to mental health care services by developing a crisis response program for low-income families. [9] However, due to shortages of mental health professionals and hospital beds accepting children, SASS failed to fulfill its objectives, particularly in the wake of the crisis following COVID-19. In response, Pritzker and the Illinois legislature have looked in recent years towards new legislation to tackle this concern from different angles. 

 The first significant legislation passed to mitigate the mental health aftermath of COVID-19 was Senate Bill 3617, which Pritzker signed into law on June 10, 2022. [10] Senator Laura Fine championed this omnibus bill and said she intended to help break down barriers to mental and behavioral healthcare. [11] This bill seeks to increase the number of care providers by allowing those who have been out of practice for less than five years to reactivate their license. [12] Furthermore, it expands behavioral health training and allows advanced practice registered nurses to treat patients for behavioral health. [13] Senate Bill 3617 intends to remove barriers for mental health professionals who hope to continue practicing after a break, thus improving access by expanding the workforce. This bill is significant in lessening access disparities because families who are unable to pay high prices for privatized care are often the same families who encounter the ramifications of the shortage. Lastly, it creates the Recovery and Mental Health Tax Credit, incentivizing employers to hire people in recovery, either from mental illness or substance use. [14] Ultimately, as Pritzker said, “‘we need a mental healthcare workforce that is robust enough to get people help when they need it’” – and this bill targets that exact need. [15]  

One recent program that directly caters to youth is the Pathways to Success Program, which gives people under age 21 with Medicaid access to intensive mental health services. [16] These services are divided into two different tiers, depending on the level of coordination of care needed, but the program ultimately provides home and community-based services to coordinate holistic support systems for children. [17] While this December 2022 program provides useful resources to children in need of intensive care that qualify for Medicaid, a substantial portion of children not meeting Medicaid eligibility or case severity requirements are left underserved by mental health legislation. [18] 

On August 8, 2023, Pritzker announced $10 million in grants specifically for student mental health services, attempting to better identify and provide care to school-age children and ultimately reduce disparities. [19] While Priztker’s FY 2024 budget proposal contained $22.8 million dedicated to planning implementation strategies for improving children’s mental health, his work in this domain was not finished. [20]  

Only three days later, the Illinois Senate and House of Representatives unanimously passed House Bill 2847, championed by Representative Lindsey LaPointe and Senator Laura Fine. [21] [22] Also known as the Mental Health and Wellness Act, HB 2847 requires that medically necessary mental health visits be covered by insurance for children and adults, as well as free-of-charge annual mental health prevention and wellness visits. [23] It also directs the Illinois Department of Human Services to launch a public education campaign to increase general knowledge about the importance of mental health. [24] While access restricts people from seeking mental health treatment, LaPointe said stigma can often keep people away, too. [25] Thus, the Mental Health and Wellness Act both requires insurance plans to provide mental health care with no additional cost and seeks to educate and destigmatize the Illinois population on mental health through means designated by IDHS.  

Because House Bill 2847 requires free mental health visits to become available beginning in 2025, the outcomes of this legislation cannot yet be analyzed. For Pritzker’s vision to pan out, his efforts in schools combined with the Mental Health and Wellness Act will be a turning point in the number of children able to access the treatment they need. [26] Although House Republicans have supported the intended outcomes of this plan, some have expressed concerns regarding its implementation. For example, Representative Will Hauter believes that the influx of people seeking care may overwhelm the mental health care system, which was already in such dire straits to necessitate the passing of SB 3617 in 2022. [27] Indeed, Illinois suffers from a continued shortage of behavioral health workers, particularly impacting those living in rural areas. [28] Another concern is that just because coverage is available does not mean that everyone will know where to find it [29]; Dana Weiner, Illinois' chief officer for children's behavioral health transformation, is currently analyzing the feasibility of potentially implementing universal mental health screenings in schools to address a similar concern. [30] Stakeholders are aligned with Pritzker’s efforts overall but question the efficacy of his means. Meanwhile, Pritzker said he’s fighting this battle for the long haul, intending to develop “‘the best behavioral health system in the nation.”’ [31]  

It is too soon to get an appropriate grasp on the trends in mental health after the creation of these programs, but one thing is for certain: Pritzker and the Illinois legislature do not plan to stop here. In addition to distributing federal funding to “support post-pandemic child and adolescent health,” possible plans involve developing portals for parents to help them identify available care services. [32][33] Furthermore, other proposals include mentions of advancing mental health training and outreach in schools, further promoting the accessibility of behavioral health care for youth, and targeting disparities. [34] While only time will tell what legislation will come next, the commitment of Illinois government officials to this cause certainly inspires hope. The nation’s current trajectory must not persist, and Illinois intends to be a trailblazer in prioritizing the mental health of its younger generation.

Notes

1. William Johnson, “Chicago-area workers still facing COVID's mental health effects,” Crain’s Chicago Business, March 31, 2022. https://www.chicagobusiness.com/crains-forum-workplace-mental-health/chicagos-covid-related-mental-health-crisis-persists 

2. Office of Governor JB Pritzker, “Pritzker Administration Announces $10M in Grants to Strengthen Mental Health Services in Schools,” Press Release, Illinois.gov, August 8, 2023. https://gov.illinois.gov/news/press-release.26850.html 

3. “Mental Health in Illinois,” NAMI, 2021. https://www.nami.org/NAMI/media/NAMI-Media/StateFactSheets/IllinoisStateFactSheet.pdf.

4. John O’Connor, “Illinois governor plan targets kids’ mental health crisis,” AP News, February 24, 2023. https://apnews.com/article/illinois-children-health-mental-6f99f436c148afbbdc3480202cc6be56 

5. Sarah Karp and Kristen Schorsch, “Illinois lifeline program for suicidal kids struggles amid a youth mental health crisis, staffing shortages,” Chicago Suntimes, March 11, 2023. https://chicago.suntimes.com/2023/3/11/23629334/suicide-youth-mental-health-crisis-sass-illinois-state-program 

6. Karp and Schorsch, “Illinois lifeline program for suicidal kids struggles amid a youth mental health crisis, staffing shortages” 

7. O’Connor, “Illinois governor plan targets kids’ mental health crisis”   https://apnews.com/article/illinois-children-health-mental-6f99f436c148afbbdc3480202cc6be56                                                              

8. Illinois Department of Healthcare and Family Services, “Screening, Assessment and Support Services,” Illinois.gov, n.d. https://hfs.illinois.gov/medicalproviders/behavioral/sass/sasshome.html#:~:text=This%20initiative%20rolled%20out%20on,law%20on%20August%208%2C%202003 

9. Karp and Schorsch, “Illinois lifeline program for suicidal kids struggles amid a youth mental health crisis, staffing shortages” 

10. “Governor Pritzker Signs Legislation Increasing Mental Health Workforce in Illinois,” Press Release, Illinois.gov, June 10, 2022. https://www.illinois.gov/news/press-release.25035.html 

11. “State to see increase in mental and behavioral health workforce thanks to Senator Fine law,” Illinois Senate Democrats, June 10, 2022. https://www.illinoissenatedemocrats.com/caucus-news/28-senator-laura-fine-news/4144-state-to-see-increase-in-mental-and-behavioral-health-workforce-thanks-to-senator-fine-law 

12. “Governor Pritzker Signs Legislation Increasing Mental Health Workforce in Illinois.” 

13. “Governor Pritzker signs legislation increasing mental health workforce in Illinois,” WAND, June 10, 2022. https://www.wandtv.com/news/governor-pritzker-signs-legislation-increasing-mental-health-workforce-in-illinois/article_ed91d434-e8e6-11ec-afd1-c3affe8cb002.html 

14. “Governor Pritzker Signs Legislation Increasing Mental Health Workforce in Illinois.” 

15. “Governor Pritzker Signs Legislation Increasing Mental Health Workforce in Illinois.” 

16. Theresa Eagleson, “Pathways to Success,” Illinois.gov. https://hfs.illinois.gov/medicalproviders/behavioral/pathways/families.html 

17. Eagleson, “Pathways to Success” 

18. Karp and Schorsch, “Illinois lifeline program for suicidal kids struggles amid a youth mental health crisis, staffing shortages” 

19. Office of Governor JB Pritzker, “Pritzker Administration Announces $10M in Grants to Strengthen Mental Health Services in Schools,” Press Release, Illinois.gov, August 8, 2023. https://gov.illinois.gov/news/press-release.26850.html 

20. O’Connor, “Illinois governor plan targets kids’ mental health crisis”

21. Mike Miletich, “Illinois law requires insurance coverage for annual mental health assessments,” WAND, August 14, 2023. https://www.wandtv.com/community/illinois-law-requires-insurance-coverage-for-annual-mental-health-assessments/article_88c5cbe2-3add-11ee-b944-9f8d5407bb07.html 

22.  Emily Moen, “Governor Pritzker Signs Legislation Requiring Insurance Coverage of Mental Health Prevention Visits,” Thresholds, August 17, 2023. https://www.thresholds.org/governor-pritzker-signs-legislation-requiring-insurance-coverage-of-mental-health-prevention-visits 

23. “Bill Status of HB2847,” Illinois General Assembly, August 11, 2023. https://www.ilga.gov/legislation/BillStatus.asp?DocNum=2847&GAID=17&DocTypeID=HB&SessionID=112&GA=103 

24.  Miletich, “Illinois law requires insurance coverage for annual mental health assessments” 

25. Miletich, “Illinois law requires insurance coverage for annual mental health assessments” 

26. “Pritzker Administration Announces $10M in Grants to Strengthen Mental Health Services in Schools” 

27.  Miletich, “Illinois law requires insurance coverage for annual mental health assessments” 

28. Ben Singson, “Mental Health Service Shortage Hitting Rural Illinois Harder: NAMI IL Featured,” NAMI Illinois, 2023. https://namiillinois.org/mental-health-service-shortage-hitting-rural-illinois-harder-nami-il-featured/.

29. “Understanding New Rules That Widen Mental Health Coverage,” NAMI Illinois, n.d. https://namiillinois.org/understanding-new-rules-that-widen-mental-health-coverage/.                     

30.  Katherine Davis, “Child mental health a priority for Illinois leaders,” Crain's Chicago Business, October 23, 2023. https://www.chicagobusiness.com/crains-forum-child-mental-health/child-mental-health-priority-illinois-leaders.

31. “Gov. Pritzker Announces New Behavioral Health Workforce Education Center,” Press Release, Illinois.gov, March 8, 2023. https://www.illinois.gov/news/press-release.26148.html 

32. Illinois Department of Public Health, “Gov. Pritzker, IDPH Announce $9.5M to Strengthen Mental Health Services for Youth Across Illinois,” Illinois.gov, October 24, 2023. https://dph.illinois.gov/resource-center/news/2023/october/gov--pritzker--idph-announce--9-5m-to-strengthen-mental-health-s.html 

33. Karp and Schorsch, “Illinois lifeline program for suicidal kids struggles amid a youth mental health crisis, staffing shortages” 

34. Illinois Department of Public Health, “Gov. Pritzker, IDPH Announce $9.5M to Strengthen Mental Health Services for Youth Across Illinois” 

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