Bill Overview
Title: Continuing Systems of Care for Children Act
Description: This bill reauthorizes through FY2027 two behavioral health programs for children, youth, and young adults that are carried out by the Substance Abuse and Mental Health Services Administration. Specifically, it reauthorizes (1) grants for states, Indian tribes, and localities to provide comprehensive community mental health services for children with serious emotional disturbances; and (2) a program for public and private nonprofits to provide substance use disorder treatment and early intervention services for children, adolescents, and young adults.
Sponsors: Rep. Joyce, John [R-PA-13]
Target Audience
Population: Children, adolescents, and young adults affected by emotional disturbances or substance use disorders
Estimated Size: 12000000
- The bill targets children, youth, and young adults, putting the age range approximately from 0 to 24 years based on general definitions.
- The global number of children and youth in this age range is about 3.2 billion, accounting for nearly 50% of the global population, but not all will have mental health issues.
- WHO estimates that 10-20% of children and adolescents worldwide experience mental disorders, so roughly 320 million to 640 million could need these services.
- Focusing on the bill's specific target population of those with serious emotional disturbances reduces the global estimate to the higher end of this range, say around 600 million.
- The substance use disorder treatment aspect will target young populations typically aged 12-24 with an estimated prevalence of disorders requiring treatment around 10%, leading to another significant overlap in the targeted number of affected individuals.
- The grants and services are also directed toward public and private non-profits, spreading the potential reach across varying socio-economic and geographic communities.
Reasoning
- The target population includes children, adolescents, and young adults in the US with serious emotional disturbances and substance use disorder issues, estimated to be around 12 million individuals.
- The budget limits mean that not every affected individual will receive significant services—many may receive limited assistance initially, scaling up over the next decade as services expand and budget grows.
- The policy focuses on public and private non-profits, indicating services may be more robust in areas with higher densities of these organizations.
- The impact on self-reported wellbeing will vary. Individuals in urban areas with more resources may report higher improvements initially than those in rural areas.
- Cultural and socio-economic factors will influence how individuals engage with these services, affecting self-reported outcomes.
- Not all individuals perceive changes in administrative policy immediately, leading to varied initial responses before more tangible effects surface.
- Comprehensive mental health services are likely to improve wellbeing significantly in some cases, but the extent will depend on accessibility and continuity of care.
Simulated Interviews
High school student (Seattle, WA)
Age: 16 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- This policy seems promising if it really means I can access more therapy sessions.
- Right now, it's hard to get consistent help because we can't always afford it.
- I'm hoping that this bill helps kids like me who really need it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 8 | 3 |
| Year 20 | 8 | 3 |
College student (Rural Tennessee)
Age: 22 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- It's a step in the right direction because anything that expands treatment options is good.
- I'm worried it won't reach rural areas like mine where people really need help.
- Support for recovery is crucial, and I hope this leads to more accessible programs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 3 |
Middle school student (Los Angeles, CA)
Age: 14 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 15/20
Statement of Opinion:
- I don't know much about policies, but I hope this helps with programs at school.
- More awareness and resources would be great for everyone.
- If we could have more counselors, that would be awesome.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Gap year/working part-time (San Francisco, CA)
Age: 19 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 4.0 years
Commonness: 12/20
Statement of Opinion:
- The policy should make it easier to keep getting the treatment I started.
- We've seen so many cutbacks, so if funding is stable, it should reduce stress.
- I hope programs are straightforward and easy to access.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
Recent college graduate (New York, NY)
Age: 24 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 4.0 years
Commonness: 10/20
Statement of Opinion:
- I'm hopeful that this opens opportunities for more consistent community programs.
- More funding should equate to more resources accessible for young people in need.
- We need long-term solutions, not just short-term grants, for real change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Elementary school student (Miami, FL)
Age: 7 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 6.0 years
Commonness: 7/20
Statement of Opinion:
- As a parent, I'm glad to see more support for younger children.
- This could allow us to find specialists who can address her needs early on.
- I hope Florida is part of states that get prioritized.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 5 |
Undergraduate student (Chicago, IL)
Age: 20 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 13/20
Statement of Opinion:
- If this helps maintain or improve the mental health resources on campus, that would be fantastic.
- It's challenging navigating college stress, so ongoing support is key.
- Hopefully, the universities partner effectively to maximize benefits.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
High school student (Denver, CO)
Age: 17 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- School support has been crucial, so more funding could enhance these services.
- Hopefully this new focus on mental health helps normalize seeking help.
- More comprehensive support networks would really make a difference.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
Middle school student (Houston, TX)
Age: 12 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 11/20
Statement of Opinion:
- This policy could bring more resources to our schools which currently have long waiting lists.
- If it means I can focus better and fit in with class, that's a positive.
- Hopefully, we don't just see short-term fixes but ongoing support.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
Part-time work while applying to grad school (Portland, OR)
Age: 23 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- Expanding programs could help those like me access therapy without burning through savings.
- Outpatient community programs could be an immediate benefit.
- The focus on young adults is encouraging.
- Anxiety makes impeding transitions like job hunting more manageable.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 3 |
Cost Estimates
Year 1: $600000000 (Low: $500000000, High: $800000000)
Year 2: $640000000 (Low: $520000000, High: $850000000)
Year 3: $680000000 (Low: $540000000, High: $900000000)
Year 5: $720000000 (Low: $550000000, High: $950000000)
Year 10: $800000000 (Low: $600000000, High: $1000000000)
Year 100: $1500000000 (Low: $1000000000, High: $2000000000)
Key Considerations
- The expected outcomes of improved mental health services include better social and health outcomes for youths, which may result in long-term societal cost savings.
- Coordination among federal, state, Indian tribes, and non-profits is essential for effective implementation.
- Funding determined by previous spending and inflation adjustments will heavily influence the actual costs.