IE 11 is not supported. For an optimal experience visit our site on another browser.

Amid growing crisis, federal officials call on states to prioritize youth mental health

A letter from Health and Human Services urges states to expand their services by making better use of federal resources.

Amid a startling increase in youth mental health problems, six government agencies called on states Wednesday to better leverage federal funding so they can prioritize children’s well-being.

In a joint letter, first shared with NBC News, leaders from the federal agencies called the issue a “national youth mental health crisis” and encouraged states to carefully plan how they use block grants, Medicaid state plans, waivers and other resources that come from multiple federal agencies so they are being executed without duplication. 

The plan by the Department of Health and Human Services also proposed ways for states to expand mental health services for children. It was signed by leaders from six HHS agencies: the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, the Administration for Children and Families and the Administration for Community Living.

Anxiety and depression in children were already increasing before the pandemic, and they were aggravated by lockdowns, school closures and social isolation, among other factors, experts say. Data shows that from 2016 to 2020, the number of children ages 3 to 17 diagnosed with anxiety grew by 29 percent, while those diagnosed with depression grew by 27 percent; from 2019 to 2020, the number of children diagnosed with behavioral or conduct problems went up by 21 percent.

Wednesday’s letter does not involve allocating more money to address the problem on top of funds the Biden administration has previously invested. Rather, it offers support for states, tribes and jurisdictions to maximize existing federal funding streams as part of the “whole-of-government” mental health strategy President Joe Biden outlined in his State of the Union address to transform mental health services.

As an example of ways to coordinate, it cited developing a statewide children’s mental health task force that incorporated data from various federally funded programs, including early childhood programs, Medicaid, the Children’s Health Insurance Program and others, to find gaps where states need to expand screening and treatment.

Addressing mental health has been a top goal of the Biden administration and HHS Secretary Xavier Becerra, who is on a national tour to hear from Americans about the challenges they are facing. 

“At HHS, I have called on our leaders across the entire Department to work together and pull every available lever to support President Biden’s call to strengthen the mental health of Americans,” Becerra said in a news release. “Today, we are calling on our state, tribal, and community partners to do the same, especially for our littlest ones.”

The plan comes at a time when there is an increase in children and adolescents needing care but there are far too few staff members to help them, said Ariste Sallas-Brookwell, a licensed clinical social worker who is the director of behavioral health integration at Mary’s Center, a community health center serving nearly 60,000 people of all ages throughout the Washington, D.C.-metro area. Mary’s Center is a Health Resources and Services Administration grant recipient.

“There’s a significant gap between the number of providers we have to provide services to kids and the need, the demand, we’re seeing for those services,” Sallas-Brookwell said.

The pandemic magnified children’s problems, she added.

“We’ve seen increases of anxiety, depression, suicidal ideation and self-harm,” she said. “We know parents and caregivers were a lot more stressed because they didn’t have the same child care or family support. They were financially strained. All of those things impact children.”

In exclusive interviews before HHS’s plan was released, two federal agency leaders who signed the letter expressed optimism that it would dovetail well with efforts already underway by the Biden administration.

The budget request for the 2023 fiscal year, for example, would make a “sizable commitment” to training more behavioral health providers, said Health Resources and Services Administration Administrator Carole Johnson.

Her hope is that the HHS plan reveals to states that there are multiple ways to leverage federal grants to get more mental health services for kids.

“We think there’s a lot of opportunity here, and we want to work with our state partners to identify those opportunities,” she said. 

January Contreras, the assistant secretary at the Administration for Children and Families, described the plan as “breaking down silos” between agencies. 

“The value that we share is that mental health for youth is just as important as physical health,” she said. 

In addition to building up the workforce so there is more access to mental health care for children, Contreras said she hoped the plan would make youth mental health care more equitable. The workforce should be boosted “in a culturally competent and multilingual and geographically diverse way,” she said. 

Contreras, Johnson and several other letter signers will hold a roundtable discussion Wednesday afternoon with people who provide mental health services to hear about their experiences delivering care and to identify collaboration opportunities. 

It’s incredibly important that we invest in programs that support children and adolescents so we prevent outcomes that are worse down the line.”

Sallas-Brookwell, who will be at the roundtable, said the workforce shortage in her industry is among the most urgent priorities to be addressed to help children.

“If we are able to intervene early on in life, we’re often able to prevent more serious illness later in life,” she said. “It’s incredibly important that we invest in programs that support children and adolescents so we prevent outcomes that are worse down the line.”

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit for additional resources.