Should School-Going Children Receive Free Mental Therapy?

Mental health is described as emotional, psychological, and social well-being. It helps to determine how to feel, think, and act. It also helps how to handle stress and make decisions.[1]

Mental disorders or illnesses involve serious changes in the way children feel, think, behave or learn, or a combination of these. It is associated with the distress caused in social, work, or family activities. Children experience stress, fear, anxiety, and worries.[2][3][4]

The mental disorder includes depression, psychoses, bipolar disorder, dementia and developmental disorder including autism.

Globally, 10-20% of children and adolescents suffer from mental illness but the majority of them do not ask for help or receive mental therapy. Half of the cases begin at 14 years of age. The third leading cause of death is suicide in the age group of 15-19 years old.[5]

In this article, we will study a brief of psychological therapy, types of psychotherapy, and data and statistics on mental health in India and the USA. we will also highlight how much to be paid to therapists, should mental therapy be free for school-going children, and ways to find free or low-cost mental therapy for children at the end.

A brief Overview of Psychological Therapy:

Psychotherapy helps people in varieties of mental illnesses, disorders, and emotional difficulties. It is also meant to guide the child so that they can manage to resolve problems and modify their behavior and function well at home, school, and community. The parents-focused approach defines the parent’s talk with the therapist about their child’s mental health, behavior, and feelings. Therapy with the child includes playing, talking with some other activities so that the child expresses feelings and thoughts. Therapists also observe the bond between parents and child and also suggest to interact in better ways to enhance the benefits of therapy.[6][7]

National Mental Health Policy, 2014

India has adopted the National Mental Health Policy (NMHP) in 2014 which is meant to guide and help actions to scale up the mental health programs and activities in the country. This policy laid down a special emphasis on the vulnerable groups such as orphans with mental illnesses, children in custodial institutions, and children of persons with mental illnesses.[8]

Types of Psychotherapy:

Numerous forms of psychotherapy involve different approaches, techniques, and interventions. Sometimes a combination of various psychotherapy approaches benefits the client. In some cases, a combination of psychotherapy with medication seems to be beneficial.

Acceptance and Commitment Therapy (ACT):

ACT therapists guide children to understand and accept their inner emotions and emotional struggles, commitment and move forward positively.

Cognitive Behavior Therapy (CBT):

During CBT sessions, a child and teens learn to identify harmful thought patterns. The child replaces this thought pattern with the right thoughts that leads to appropriate feelings, mood, and behavior. CBT was found to be effective in conditions like depression and anxiety.

Dialectical Behavior Therapy (DBT):

DBT sessions are useful to treat older adolescents having chronic suicidal thoughts, self-harmful behaviors, or personality disorders.

Family Therapy:

Family therapy sessions include the child, adolescents, siblings, and grandparents. This therapy helps the family to function in constructive ways by providing effective communications and support.

Interpersonal Therapy (IPT):

IPT therapists focus on interpersonal events and how it has affected individuals’ emotional state. This therapy is tested and developed for depression and found effective for other mental illnesses too.

Mentalization-Based Therapy (MBT):

MBT therapy helps children and teens who put effort and struggle with their own identity and who they are.

Parent-Child Interaction Therapy (PCIT):

PCIT therapy involves the interaction of parents with their child and guides families for positive and real-time coaching sessions.

Play Therapy:

It involves the use of toys, puppets, and dolls to recognize, identify, and verbalize the feelings of the child. The therapist observes the child and way of using play materials and themes to know the child’s problems and manages their conflicts, behavior, and feelings.

Psychodynamic Psychotherapy:

Psychodynamic psychotherapy is based on the assumption that a child’s behavior, thoughts, and feelings will improve if the inner struggles are resolved. The session helps to understand a child’s typical behavior patterns, inner conflicts, and struggles. Psychoanalysis involves several sessions a week.

Supportive Therapy:

This therapy support children and teens in their lives to cope up with the stress, unhelpful behaviors, and low self-esteem.[9]

Data and Statistics On Mental Health:

In India:

10% of children aged 5-15 years old are diagnosed with a mental health disorder. This data states that around 50 million children under 18 years old will benefit from psychotherapy. 20 million adolescents are suffering from mental health illnesses.

Approximately 90% of children with mental health disorders are not receiving specialist therapy.

In the USA:

9.4% of children or around 6.1 million aged 2-17 years are diagnosed with ADHD. 7.4% of children or around 4.5 million aged 3-17 years old are diagnosed with behavior problems. 7.1% of children or around 4.4 million aged 3-17 years have been diagnosed with anxiety. 3.2% of children or around 1.9 million aged 3-17 years diagnosed with depression.

78.1% of children aged 3-17 years received treatment for depression. 59.3% of children aged 3-17 years received treatment for anxiety. 53.5% of children aged 3-17 years received treatment for behavior disorder.[10][11]

Cost of Receiving Mental Health Therapy:

The average cost of therapy generally ranges from $65 to $250 per hour or more. In most of the country, therapists are paid $100-$200 per session.

When people prefer to pay for therapy through insurance, they have to meet certain criteria like mental health diagnosis and getting a referral for the treatment. Insurance co-pays differ widely, from just a few dollars to $50 or more.[12]

Free or low-cost mental health care- should be provided to school-going children?

Its definite yes-yes by looking into the data and statistics on mental health concerns for children which is disheartening and the expected average cost of therapy per session given to the therapists could not be afforded by all, free or low-cost mental health care should be received by school-going children.

The schools are an ideal place to get mental health services for children. Children spend around 6 hours a day in schools. School-employed professionals like school psychologists, school social workers, school counselors, and school nurses get to know the students, parents, and other staff better, contributing to the accessibility of services.

Research has found that students are likely to seek counseling when mental therapy is available in schools. Comprehensive mental health services are most effective in schools when provided by the multi-tiered system of supports (MTSS) but schools generally employ mental health professionals.

MTSS approach helps to understand the need, enabling schools to promote mental health awareness for all students, identify and address the cause before it becomes chronic by providing intensive and data-driven services to those who are in need.

There are several plans implemented by the government and world health organization related to mental health which include:

  • Child and adolescent mental health policy
  • School mental health policy
  • Mental health policy for the disabled.

We need to maximize the advantage of these three policies where programs and funds are structured in favor of child mental health. The National Association for Free and Charitable Clinics also offers free and low-cost care.[13]

Ways To Find Free Mental Therapy For School Going Children:

  • Enrolling yourself in studies related to mental health conditions. You can usually get free care, like medication and therapy, by getting enrolled in such studies.
  • Local mental health centers and clinics are generally funded by central and state governments so that you pay less than the private therapist.
  • You may visit websites like the National association of free and charitable clinics to avail the services. The U.S. Department of Health and Human Services also offers a list of clinics and centers which are federally funded by the state.
  • Employee Assistance Programs (EAPs) are free programs that provide professional therapists to evaluate employees and their children under the scheme for mental health conditions and also offer short-term counseling.
  • Programs like Medicaid or healthcare.gov or the State Children’s Health Insurance Program (SCHIP) offer free or low-cost medical insurance to teens. People under age 18 will need the signature of either parent or guardian on the paper for these programs.[14]

Summary:

Mental therapy is the need of the hour in children and youth who are suffering from mental and emotional distress. There are rising cases among school-going children aged 5-18 years with depression, anxiety, suicidal thoughts, and behavioral problems, etc. Psychotherapy may help the children, teens, and youth to resolve their problems, learn how to behave, act and feel, and function well with peers, community, and at home. There are various kinds of psychotherapy exercised by therapists depending on the severity of the case. They may use either one or a combination of these therapies to combat mental and emotional challenges. School-going children are the future of the nation and it becomes imperative at the same time to get access to specialist services. Free or low-cost services should be available for children as discussing mental health is still a stigma and nobody appreciate it if individuals suffer from it. School-going children could not afford to pay the therapist if not supported by parents, which result in rising in untreated cases. To raise awareness and promote the significance of mental health, various policies, initiatives, and activities held. We need to maximize the advantage of these to lead a healthy life.

References:

  1. What Is Mental Health? https://www.mentalhealth.gov/basics/what-is-mental-health.
  2. Mental health symptoms in school-aged children in four communities https://www.cdc.gov/childrensmentalhealth/features/school-aged-mental-health-in-communities.html
  3. What Is Mental Illness? https://www.psychiatry.org/patients-families/what-is-mental-illness
  4. Mental disorders https://www.who.int/news-room/fact-sheets/detail/mental-disorders
  5. https://www.who.int/activities/improving-the-mental-and-brain-health-of-children-and-adolescents
  6. https://www.cdc.gov/childrensmentalhealth/parent-behavior-therapy.html
  7. What is psychotherapy? https://www.psychiatry.org/patients-families/psychotherapy
  8. Sharma. Eesha, Kommu.Johan Vijay Sagar, Mental Healthcare Act 2017, India: Child and adolescent perspectives, Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482686/
  9. Psychotherapy for Children and Adolescents: Different Types https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide
  10. Shastri.PC, Promotion, and prevention in child mental health, Page no. 88-95, Retrieved from https://www.indianjpsychiatry.org/article.asp
  11. https://www.cdc.gov/childrensmentalhealth/data.html
  12. How Much Does Therapy Cost? https://www.goodtherapy.org/blog/faq/how-much-does-therapy-cost
  13. School-Based Mental Health Services: Improving Student Learning and Well-Being https://www.nasponline.org/resources-and-publications/resources-and-podcasts/mental-health/school-psychology-and-mental-health
  14. Finding Low-Cost Mental Health Care https://kidshealth.org/en/teens/mhealth-care.html

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