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Alarm on children's mental health has been ringing for decades. Too few have listened.

Despite claims that children’s mental health is a “national emergency,” the current situation doesn’t meet that definition, i.e., “a serious, unexpected, and often dangerous situation requiring immediate action.”

Children’s mental health – and the lack of access to appropriate and effective services – is a long-standing problem that hasn’t been addressed with urgency and systematic long-term action. In 1959, George Albee, early in his legendary career as a leader in the field of prevention, completed what was then known as the “manpower” report on mental health and concluded that it wouldn’t be possible to provide professional clinical treatment for all those who need it, combining the efforts of all mental health fields. Nothing has changed since that assessment.

Reports coming out of the Office of the Surgeon General since 1999, as well as a series of research studies since the 1950s, also noted that even when services are available, they aren’t equitably distributed. People at the intersection of these attributes – poor, Black/Latino and children – have long been underserved and inadequately served by the mental health system.

No 'immediate action' can help crisis

Reports such as those published in the Journal of the American Medical Association Pediatrics have reported alarming increases in children’s anxiety and depression between 2016 and 2020. But the alarm bell has been ringing for decades. Too few have listened.

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There are complicated reasons why the situation seems to have more urgency, and I believe it is partly because white and middle-class and affluent families are having difficulties obtaining timely mental health care for their children. It also is likely that demand for mental health services has passed a “tipping point.” New light is being shed on the relatively small percentage of Blacks and other nonwhite people who are entering the mental health field as well as the small percentage within that group specializing in working with children.

This can’t and shouldn’t be surprising. As Black and Latino populations have been let down by the mental health system during their youth, one can hardly expect the field to be attractive to them.

Indeed, the failures of the system have impaired the likelihood of having the experiences, grades and resources for college, graduate school and licensure. A recent report from National Public Radio illustrated this process in school psychology, where less than 1% are estimated to be Black in a field where the ratio of school psychologists to schools already is inadequate in many areas. This isn’t a formula for encouraging entry into, and longevity in, a given field.

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There can be no “immediate action” that can rectify this situation. Calls for greater availability of telehealth services and online resources, including books, are examples of first-order change. There will also be inequities of access and effectiveness with regard to these alternatives to accessing in-person therapy.

While we attempt to do as well as we can in the current situation, we must work to redress a matter that truly is dangerous and serious and meriting sustained attention.

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Albee, once again, was prescient when he said, “No mass disorder afflicting humankind has ever been eliminated or brought under control by attempts at treating the affected individual.”

Treatment is good, prevention is better

Trained as a clinical psychologist, Albee understood the value of treatment for individuals. However, he also knew prevention was the only viable public health strategy – as we have found out with COVID-19 vaccines.

Since Albee’s statement in 1998, considerable research has been devoted to outlining evidence-based approaches to preventing mental health difficulty. Many of these are located in schools, and many of them have been captured in compilations of effective programs by the Collaborative for Academic, Social, and Emotional Learning and the resources of the Social Emotional Learning Alliance for the United States and Character.org.

My twin died by suicide. I’ve been too ashamed to talk about it – until now.

The pathway toward schools being places that are enhancing of student (and staff) mental health is one that typically takes three to five years, if backsliding is to be minimized. Thus, the most immediate public health action we can take is to ensure schools are systematically and irrevocably committed to and supported while bringing in the processes and programs needed to build all students’ social, emotional, character and civic competencies.

Let’s be clear: The mental health of our nation’s children should have been a concern of ours for many decades. We might have reached a tipping point in its competition for attention and resources with other national problems. It can't be improved through treatment alone, nor through any immediate steps.

That said, committed action toward policies that will support prevention and ensure equitable access to effective resources must begin now. This requires a focus on our entire education system (prekindergarten through college) and its interface with public health, with a long-range perspective that spans political cycles.

Maurice J. Elias, Ph.D., is a professor of psychology at Rutgers University and the director of the Rutgers Social-Emotional and Character Development Lab.

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This article originally appeared on USA TODAY: Children's mental health: How to help schools so we don't fail kids