Youth mental well-being and resiliency
[Music]
[Dr. Gary R. Maslow]
So, a lot of young people feel hopeless at times, and that hopelessness is often a really intense feeling and is one that you can get through.
[Screen text] Dr. Sy Saeed, Executive Director, North Carolina Statewide Telepsychiatry Program (NC-STeP), Director, Center for Telepsychiatry and e-Behavioral Health, East Carolina University
[Dr. Sy Saeed]
Youth mental health has become a public health challenge and a problem.
[Brian]
[Screen text] The suicide rate among North Carolina teens ages 15-19 rose 35% in a decade
Suicide rate has increased for youth overall.
[Screen text] Brian Brooks, VP, Behavioral Health
The increases in suicide are a crisis because we don't have the services where the child needs them.
[Dr. Sy Saeed]
In North Carolina, out of a hundred counties, 94 are considered mental health workforce shortage area by federal criteria.
[Screen text] 94 out of 100 counties are considered mental health workforce shortage areas
[Screen text] 60 counties don’t have a child psychiatrist
[Dr. Maslow]
There are 60 counties that don't have a child psychiatrist in North Carolina. In those counties, the primary care providers are providing mental health care for children.
[Screen text] Gary R. Maslow, Child and Adolescent Psychiatrist, Director of North Carolina Psychiatry Access Line (NC-PAL: Pediatrics)
[Brian]
We have to intervene to be able to ensure the future of North Carolinians. It's really the partnerships. It's not Blue Cross Blue Shield North Carolina doing the work alone.
We're partnering with 988 and Crisis Support Services. We are working with providers to build in-school counseling, and we've, over the last couple of years, opened up counseling codes to actually be allowed in school that previously weren't allowed.
We're supporting the evidence-based practice by having that training platform for providers to be able to train. We're supporting value-based payment models that actually incentivize using those screening instruments once you're trained on them. So, we're supporting all of those, and then many, many other things as well.
[Dr. Sy Saeed]
How can we catch them early, intervene using evidence-based care early? That's where NC-STeP provides this continuum. So, we start with pediatric clinics, so working with children and youth.
So, for example, for anxiety, we use a screening test, which is basically seven questions. For depression, we can use a test that uses nine questions.
[Screen text] GAD-7 Test, seven questions; PHQ-9 Test, nine questions
When a provider is not available in a community, we can bring that provider using telehealth, telemedicine, telepsychiatry.
[Dr. Maslow]
NC PAL is a consultative program that provides real-time consultation to primary care providers who are caring for children with mental health conditions. It serves as a workforce multiplier. In North Carolina, we've worked with 1100 primary care providers, and those primary care providers care for 400,000 children just who have Medicaid coverage.
[Screen text] 1,100 primary care providers; 400,00 children
The core idea of this to create a community. To do that, we will go to them and meet with them. So, when we first started working in Vance County, one of our child psychiatrists would drive out to all the practices, driving an hour and a half and bring donuts and say, "We're here. We want to meet with you and figure out what your needs are."
About over half of the primary care providers in that county have used the service. Primary care is very local, and rural communities are very local. With very small changes, we're able to help someone who had been stuck for two years get treatment.
If we're successful, each time we get a call, there's a parent on the other side of that exam room who feels like they know what to do to help their child and is less worried.
The only way that we get through the pediatric mental health crisis is together, and that ranges from primary care providers, parents, community members, insurance companies, the state, employers, schools.
[Brian]
Nobody can do this alone.
[Dr. Sy Saeed]
Ultimately, what I'm hoping from all of this is that we are resulting in a place where a child is more resilient.
[Dr. Maslow]
And kids who were hospitalized that I worked with 15 years ago are now working and thriving and have kids of their own.
[Screen text] More young people are finding hope. We won't stop until every child does.
[Screen text] Blue Cross Blue Shield of North Carolina
BlueCrossNC.com/NCYouth
Learning from listening
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is partnering across the state to make a difference for our youth.
From 2021 to 2023, executives joined in conversations with business, health care, education, and public policy leaders in all 100 North Carolina counties. They shared their priorities and concerns, and no concern was more urgent than helping children and young people – many of whom feel anxious, sad, and lost – find a sense of purpose, belonging, and connection in their communities.
In North Carolina, there is no health challenge more urgent than the youth mental health crisis. The numbers alone are alarming:
Taking action
Expanding access to high-quality care
Children and teens facing mental health issues need to know that there's someone there to help them get through. So do their parents and guardians.
We're creating an expanded network of same-day mental health services to make access to care easier and faster. We're ensuring members have access to the care they need by increasing the number of in-network mental health care providers and making virtual or on-demand care more accessible.
We are also providing help navigating the mental health care system to make it less stressful to find mental health support and helping doctors connect patients with mental health professionals more quickly and easily.
Investing in preventive mental health care
We're working to bring more preventive mental health care resources to communities across the state. We're also expanding school-based counseling to support early intervention and make mental health resources more accessible in schools.
We recently joined mental health experts and philanthropic funders to create a statewide behavioral health action plan that will address pressing mental health challenges at a large-scale level.
Enhancing community support
We're bringing Youth Mental Health First Aid Training to all 100 North Carolina counties. Blue Cross NC will leverage its employees and partnerships with youth-based organizations to train people across the state, including 10% of Blue Cross NC's workforce, in Youth Mental Health First Aid by the end of 2025.
We're also enlisting employee volunteers for our Blue Corps to offer support for youth mental health in addition to their other community work. Blue Corps is our skill-based volunteering initiative that matches the expertise of our employees with local nonprofits to tackle issues.
