Sickness Behaviors

Many parents recognize increasing mental health concerns among children, reflected by the 1 in 5 who say they're open to allowing a child to take a mental health day. Many parents struggle deciding whether their middle or high school aged child should stay home from school if they don't feel well, a new national poll suggests. Among top factors: how their adolescent or teen is behaving due to symptoms and if they can get through a school day, the risk that they're contagious and whether the student will miss a test, presentation or after school activity. One in five parents also consider if their child needs a mental health day, according to the University of Michigan Health C.S. Mott Children's Hospital National Poll on Children's Health. "In some cases, the decision to keep kids home from school is clear, such as if the child is vomiting or has a high fever," said Mott Poll co-director Sarah Clark, M.P.H. "But parents often have to guess at whether their child's report of 'not feeling well' represents a good reason to miss school." The nationally representative report is based on 1,300 responses from parents of children ages 11 to 18 surveyed in February 2024. Sick day decisions go beyond physical illness More than half of parents say they're more likely to keep kids home just to be safe in situations where it's unclear how sick their child is. Another quarter of parents would send their child to school and hope for the best while less than a fifth would let their child decide. As grades become more important to adolescents and teens in junior and senior high school, many parents also include academic considerations in their sick day decision. Nearly two thirds of parents say their child worries about an absence's negative impact on grades or missing friends or school activities. Clark recommends parents ask more questions to learn about their child's request to stay home. If it's on the day of a test, she says, it may reflect their lack of preparation or anxiety about performing well. Mental health day considerations Many parents recognize increasing mental health concerns among children, reflected by the 19% who say they're open to allowing a child to take a mental health day. Clark notes that in some instances, face to face interactions may trigger or exacerbate mental health issues, such as a breakup with a romantic partner, a falling out with friends, or an embarrassing incident shared on social media. "It's understandable that students may fear facing peers in uncomfortable social situations, but they can't miss school every time they expect an unpleasant interaction," she said. "Facing discomfort is a natural part of life, and parents play an important role in helping kids to learn how to navigate these challenges in order to build resilience and develop healthy strategies for handling social stressors." In balancing their decisions about allowing their child a mental health day, parents may think about the purpose of the day away from school, she says. It may be an opportunity to help their child plan how to handle interactions, practice strategies to stay calm and ease anxiety, and identify specific peers, teachers or staff who could be sources of support. For children who have been diagnosed with depression or anxiety, missing school may be necessary to sustain the child's well-being, Clark adds. Parents should consult with their child's mental health provider for guidance. Complying with school attendance policies Nearly all parents polled say their school has an attendance policy, which they felt was necessary to ensure children go to school consistently. The majority of parents also think the amount and timeframe for making up missed schoolwork is reasonable. However, many also acknowledge that compliance with school attendance policies can be particularly challenging for children with chronic medical conditions who often miss school due to medical visits or to avoid exacerbations of their condition. "Parents agreed that attendance policies are important to preventing truancy or excessive absenteeism linked to poor school performance," Clark said. "However, parents of children with health issues that require traveling to regular appointments and even hospitalizations may need to have conversations with school administrators and teachers about the likelihood of health related absences. These families may need to enlist the child's healthcare providers for support in requesting school flexibility in completing assignments at home or with additional time."

The January 2023 decision by the Centers for Medicare & Medicaid Services (CMS) to approve an amendment to New York’s Medicaid section 1115 waiver is a welcome step forward in the expansion of accessible and affordable mental healthcare at a time of increasing need. A commitment to improved mental health rests at the core of the $7.5B waiver, which will enable New York State to invest nearly $6B of federal funding into the state’s healthcare system over the next three years. The state can now integrate primary and behavioral healthcare services to improve health equity for high-risk populations, including children, maternal patients, and those with substance use disorders (SUDs). As federal and state governments continue to emphasize the need for integrated care, a renewed commitment to funding and supporting child, perinatal, and SUD psychiatry access programs will be central to this effort. Access programs – which support primary care providers to deliver behavioral healthcare through education, training, and specialty peer-to-peer psychiatric consultations – are being implemented in nearly every state in the nation to provide accessible behavioral healthcare amidst a scarcity of providers and resources. By expanding access to scarce behavioral health resources, access programs ensure that essential specialty care can be delivered to vulnerable groups that need it most urgently. This expansion not only improves accessibility but also helps limit the burden on an already overstretched system of behavioral health providers. It may also represent a cost saving to governments, allowing specialty-level care to be administered by less costly primary care providers within the health system. Yet, with many programs reliant on time-limited federal or state grants for operations, stable, recurring funding is essential. Far fewer have access to stable, recurring funding through alternate sources. For state access programs to continue expanding care, federal and state governments must commit ongoing resources to their sustainability and growth. The Access Program System: A Leading Example If we are to continue bridging these gaps, federal agencies and state legislators must consider allocating recurring funds to access programs across the nation. The nation’s first access program, the Massachusetts Child Access Psychiatry Program (MCPAP), offers a vital example of the value of this model. Founded in 2004, MCPAP, funded primarily by the Massachusetts Department of Mental Health and in part by major commercial insurance in the state, has facilitated a program to mitigate the state shortage of child mental health professionals for 20 years. Throughout the program’s history, this goal has been met through a variety of services coordinated through primary care providers (PCPs), including telehealth services for child psychiatry consultations, in-person appointments and overall care coordination. All children and their families in Massachusetts have had free access to the program through their PCPs, regardless of insurance coverage. In recent years, the program has also partnered with the Boston Children’s Hospital Adolescent Substance Use and Addiction Program (ASAP) to address the increasing use of substances in teens. What Massachusetts and other CPAPs offer is coordinated, specialist-level patient consultation and care management for behavioral health conditions and substance use disorders. By supporting PCPs to communicate with, and refer to, psychiatrists and other behavioral healthcare providers, scarce behavioral health resources are stretched to deliver better care to more people. In FY2022 alone, MCPAP conducted over 12,000 encounters, including over 7,500 phone consultations and nearly 3,000 face-to-face consultations. In educating PCPs, MCPAP, and other access programs, both support patient care and empower PCPs to continue delivering specialty-level care in the future; studies of the program have shown that 77% of enrolled PCPs feel comfortable treating ADHD, while nearly 70% are comfortable treating depression and anxiety. Ongoing funding supports access programs Mental health services are vital to the overall health of our youth now and in the future. As funding for state access programs differs in each state, children and adolescents are at risk of not receiving adequate mental health services. With an election year upon us, healthcare funding will be a crucial area of deliberation. Recent results from the State of Kids and Families in America 2024 report show that 30% of child and teen respondents identify mental health challenges as the primary concern they face today. Other data confirm the same challenges among children and youth. The Center for Disease Control and Prevention’s 2021 Youth Risk Behavior Survey results found that 3 in 5 girls felt persistently sad and hopeless. Almost half of LGBTQ student respondents seriously considered attempting suicide, nearly 1 in 4 attempted suicide, and almost 3 in 4 reported persistent feelings of sadness or hopelessness. In a patchwork system that supports behavioral healthcare across the nation, innovative funding measures like New York’s Medicaid waiver amendment will introduce new opportunities for behavioral health services that cover vulnerable populations: youth, maternal patients and those with SUDs. Surgeon General Vivek Murthy recently described mental health as “the defining public health crisis of our time.” No crisis can be tackled without the proper tools. As the burden of mental and behavioral illness continues to rise, now is the time to invest in the future well-being of our population.

MEDFORD, Mass. & COLORADO SPRINGS, Colo.--( BUSINESS WIRE )-- Innovive Health , a data-driven home health care agency serving complex behavioral health patients, today announced that it is expanding its groundbreaking behavioral health home care model to Colorado. The expansion comes as the nation’s health care system is facing a growing patient population with behavioral health needs and unprecedented staffing and economic pressures in the wake of the pandemic. Building on the agency’s growing operations in Massachusetts, which currently cares for more than 20,000 patient visits each week across the state, Innovive Health has acquired a license to operate in Colorado. “Nationally, there has never been a time when the need for mental health services in home or community settings have been more paramount. This expansion to Colorado not only helps meet this growing need, but also validates our innovative care model,” said Joseph McDonough, Founder and CEO of Innovive Health. “Our dedicated team of caregivers is proud to bring our model of care to Colorado and to care for patients where they need it most – in the safety of their homes and not in the emergency department." Operating out of Colorado Springs, Innovive Health already has a small staff of nurses on board who have begun seeing patients. Innovive Health’s unique home health model focuses on patients who have multiple medical comorbidities with complicating behavioral illness, treating and educating patients on their holistic well-being. With a deep understanding of the dynamics of the evolving data-driven healthcare market along with a proven track record of adopting new technologies – such as a cloud-based infrastructure and a fully integrated EMR – Innovive Health is well positioned to rapidly scale its services in new markets such as Colorado. “We are pleased to start operations in Colorado, which has demonstrated the state’s dedication to increasing access to care for behavioral health patients by earmarking $547 million to behavioral health projects for Coloradans,” said Nicholas D’Addabbo, Vice President of Strategy of Innovive Health. “With over 82,000 outpatient behavioral health visits in Colorado Springs in 2019 and more than 18 percent of Colorado Springs adults reporting having experienced a behavioral health disorder in the last year, increasing access to home and community-based supports for patients with comorbid behavioral and physical illness is imperative.” Since its inception in 2004, Innovive Health has played a vital role as the hub for a complex care team – coordinating with a multitude of specialists and providers across the continuum of care. For nearly two decades, the innovative home healthcare agency has built a strong clinical and operations team while establishing and expanding the company’s partnerships with healthcare organizations and world-class technology companies to fundamentally change the way care is delivered to this population. Innovive Health provides skilled nursing services in the home with specialty programs to assist in the overall treatment and management of comorbid disease processes. “Based on our track record serving some of Massachusetts most vulnerable behavioral health patients, I’ve seen how home healthcare can remove the social barriers to continuing care and reduce unnecessary utilization of high-cost ED and hospital visits,” added McDonough. “Our complex behavioral health patients have at least one severe mental health diagnosis with an average of 10-12 medical comorbidities – they also take up to 10-15 medications and often live in communities with less access to care. Given our experience with this patient population, we are well positioned to have an immediate impact in treating similar patients in Colorado, which will help deliver better patient outcomes while taking pressure off the healthcare system.” To learn more about Innovive Health or to make a referral, please visit https://innovivehealth.com . About Innovive Health With operations in Massachusetts and Colorado, Innovive Health is one of the nation’s fastest growing home healthcare agencies focused on serving complex behavioral health patients. Innovive Health has been delivering strong clinical outcomes for nearly two decades and is transforming healthcare through an innovative model of patient-centered, data driven, full-service home care. The agency provides high quality nursing and services to some of the nation’s most vulnerable and underserved populations in the safety and comfort of their homes and communities. For more information, visit https://innovivehealth.com .