Youth mental health services
Neil Harrington is the research director at NC Child. He unveiled the child report cards for four Cape region counties, New Hanover, Brunswick, Pender, and Columbus, at the New Hanover County Resiliency Task Force’s August event.
Harrington reported that 54% of North Carolina children who need mental health care have difficulty or cannot access these services. Additionally, 40% of the state’s high schoolers report persistent feelings of sadness or hopelessness.
“The number of kids diagnosed by medical professionals with anxiety or depression has more than doubled since about 2016, and at the same time, right up between 2010 and about 2023, we've seen the number of youth suicides in North Carolina more than double,” he said.
The increase in students struggling with mental health is complicated by a shortage of professionals who can help them, according to Harrington.
“For school psychologists and social workers, so in all of those counties, in Columbus, Pender, Brunswick and New Hanover, the ratio of students to [these professionals] is more than double [the recommended level],” he said.
The nationally recommended ratio for students to school psychologists is 500 to 1. For social workers, it’s 250 to 1.
No Cape region district meets the recommended counselor ratios, either.
J’vaneté Skiba is the director of the New Hanover County Resiliency Task Force. She said that while her organization wants to see more professionals in the schools, they’re tasked with helping students and teachers alike handle the youth mental health crisis.
“We are going back to the neurobiology and the physiology of stress, so we start with our nervous system, and we hope people build skills to recognize those signs of dysregulation in themselves, and how to apply skills that have been found to bring that sense of calm. But what's really happening is that we're giving our bodies and brains the ability to get back to that place of stasis over time. What that does is it increases our physical and mental resilience. Biological resilience is really what we try to focus on,” she said.
Skiba added that those in attendance brought up ways to find money to support these positions. One was for the legislature to fully fund the Leandro Plan, which would provide millions more to school districts around the state, and additional positions for mental health providers.
The Republican-controlled state Supreme Court hasn’t issued a final ruling on Leandro funding, but they reversed the previously Democratic-led court’s order for the legislature to release the funds to public schools. The GOP-legislature argued that the judicial system doesn’t have the power of the purse. Additionally, some Republican lawmakers said they’ve already funded parts of the plan.
To address the stark statistics on youth mental health in the NC Child report, Skiba said it requires educators and parents to employ the skills of emotional regulation, resiliency, and trauma-informed practices.
“If we give them the tools that they need to be more resilient, then we can decrease the likelihood that they will re-traumatize the children who they may serve. With this data going back to youth mental health, how are we bridging that gap as a community until those numbers can improve?” Skiba said.
While Skiba said it takes personal and professional development to improve these outcomes, Harrington said it’s also about increasing pay for counselors, social workers, and school psychologists. Another layer is how many future professionals are actually going into workforce pipelines.
“The issue is that we really don't have enough graduates of school psychologists out of North Carolina institutions to really kind of meet that need. So there's about five schools in North Carolina that have [these] programs and that they only graduate about 30 people per year. And so the part of solving the staffing on the school side is to figure out how we solve that pipeline issue,” Harrington said.
Child uninsurance rates
While the child uninsurance rates have been declining with the expansion of Medicaid services, there have been recent cuts to the program from the federal government, and the state legislature has yet to decide how they are going to deal with them. Some have surmised that they could decrease reimbursement rates or cut some people and services altogether.
But Harrington said he’s hopeful that the recent improvements in insurance rates will hold and aren’t “negatively affected by any recent changes.”
Skiba said child advocates in the region are concerned about the Healthy Opportunities Pilot (HOP) ending. It was a program where community groups provided food, counseling, or housing/transportation navigation services; those groups could then be reimbursed through Medicaid. The program didn’t make it into the legislature’s stopgap ‘mini-budget’ – a full budget still hasn’t been negotiated by the state house and senate – and HOP had to end July 1.
“Those folks were being supported through Medicaid dollars, and so that conversation is what really came up, how a program that was shown to be effective, that helps support vulnerable children and families get connected to much needed services would no longer be provided,” Skiba said.
Another improvement, along with the increase in insurance rates, is that the number of children living in low-income homes has also declined.
“That's also declined pretty steadily over the past 10 years or so, and that's kind of due to several factors. One of those being those investments in public support programs, but also we've seen, for the most part, a strong labor market over the past decade or so, except for that brief period during Covid, when everything kind of dipped for a little while,” Harrington said.
High quality access to early childhood centers
There are also concerning trends in third grade reading scores. These metrics can be predictive of achievement on future tests, high school graduation rates, college attendance, and the amount of money a person can make throughout their lifetime, according to Harrington.
Notably, these scores have not aligned back to previous proficiency levels from before the pandemic.
“It's been really difficult for counties and school districts across the state to really catch back up to that. And so in the presentation, I talked about how, pretty much every [Cape Fear region] county, all of them are still kind of below the rate that they were at just before the pandemic, and that really kind of matches the state's trend as well,” he said.
For Harrington, a way to improve these reading proficiency scores is to start as early as possible, with improving the early childcare industry. NC Child compiled data that availability of these centers in these centers doesn’t match the need.
The demand is there, but there aren’t the high-quality centers available, and when they’re available, they are very expensive.
“The average cost of infant and toddler center based child care is more than the cost of in-state tuition at UNC Chapel Hill, for the most recent academic year. So it's gotten more expensive to go and send your kids to an early childhood education program,” he said.
He said, according to the Untapped Potential report that NC Child worked on with the North Carolina Chamber of Commerce, that high costs or unavailability of care have led parents to drop out of the labor force, which costs the state $5.6 billion in economic growth. If these issues were solved, though, the report claimed North Carolina could see up to a $7.5 billion increase in gross domestic product (GDP), which would include adding up to 60,000 new jobs with parents returning to the workforce.
North Carolina Governor Josh Stein has created a bipartisan task force to look into ways to fix the industry. One of the strongest recommendations so far, Harrington said, is to give centers higher subsidy reimbursement rates for those who run the centers.
