Ask an Expert: Child Mental Health and Current Policy with Janet Cummings

Recent federal data show rising rates of mental health diagnoses among children across all demographic groups, while access to care remains limited—especially in Georgia.

In this interview, we share insights from Janet R. Cummings, PhD, professor of health policy and management. She is a nationally recognized expert on access and quality of behavioral health care, particularly for the needs of underserved populations with mental health and substance use disorders. Learn about current trends in child mental health, the impact of recent funding cuts, and what parents need to know.

What’s the most important thing parents should know about the state of child mental health right now?

Parents need to know that there have been major federal cuts (and more impending cuts under discussion) to systems that serve children at a time when our nation is experiencing a child mental health crisis.

Current trends indicate that child mental health is declining. My recent research showed that the number and percent of children on Medicaid diagnosed with a mental health disorder have increased substantially within a recent nine-year period.

We saw these increases for every demographic subgroup we examined—including age group, sex, race, and ethnicity. The trends in our study are consistent with what other data sources have found for privately insured children.

It is also important to keep in mind that the rates of mental health diagnoses we found are conservative because we used insurance data. The actual rates of children who experience mental health disorders are higher when accounting for those who have not been diagnosed and those whose families faced barriers accessing the mental health system.

Why are child mental health diagnoses increasing?

We need to do a better job of understanding the causes that are contributing to these trends—this is an under-researched area. One of the major changes in the past 15 years that deserves more attention is the time children and adolescents spend in the digital world, including engaging with social media, video games, and other online platforms.

The Surgeon General’s Advisory on Social Media and Youth Mental Health is an excellent resource that has some practical guidance for parents. However, we really need more rigorous research on these topics (which depends heavily on federal funding) to better understand the connections between how kids are engaging in the virtual world and the implications for their mental health and well-being.

What should parents know about how potential cuts to public services will affect child mental health?

Our mental health treatment systems have been chronically underfunded, and these systems need additional investments to make sure that kids with mental health disorders can get the help they need. But things are moving in the opposite direction at the federal level.

The Department of Education is cutting $1 billion in federal mental health grants that were supposed to help train mental health professionals to work in local schools. The Substance Abuse and Mental Health Services Administration (SAMHSA) is facing more than $1 billion in budget cuts and a potential 50% reduction in workforce.

SAMHSA is the federal agency that is responsible for reducing the impact of mental health and substance use in our communities and supporting our mental health and substance use treatment systems. With federal funding cuts at these levels, state governments are going to have to look at what resources have been lost and where they would be willing to make up the difference.

How does Georgia compare to other states when it comes to access to care?

Access to mental health services is a real problem in Georgia. In 2024, our state was ranked 47th in the nation by Mental Health America on mental health care access. Out of the 159 counties in Georgia, 153 are designated as mental health shortage areas that do not have enough mental health providers to serve the population in the county.

The findings from the recent State of Child Health and Well-Being in Georgia survey showed high numbers indicating mental health need among children in Georgia, either among children that had been diagnosed or suspected to have a mental health condition. And yet, parents reported that two out of three children with a mental health diagnosis are not receiving services. Much of this gap is likely due to the shortage of providers and the challenges families face accessing affordable care.  

One promising trend is the growth of the Georgia Apex program that brings community mental health providers into schools. This program started in 2015 and is now in more than 800 schools across the state. While this state-funded program plays an important role in the child mental health care landscape in Georgia, not all schools have the Apex program, and it is not big enough to meet the need across the state.

In light of some of these challenges, what can parents do if they’re worried about their child’s mental health?

The pediatrician is often the best first step. They can assess what’s going on and help with referrals or evaluation. Families should also ask their child’s school what mental health resources and supports are available. There’s also a lot of information online, but not all of it is helpful or accurate. Getting some guidance from trained professionals who know your child is a good place to start.