A father and his 10-year-old son sit in the emergency department of a Connecticut hospital. His son, who is intellectually disabled and autistic, is struggling with out-of-control behavior. They lie together on a blue mat, the boy and his dad, quietly resting. Dad is resisting the time to go home, as he knows he will be leaving his young boy alone for another night in the emergency room. But there is still no place to go for his son. Connecticut has finite beds for children in mental health crisis who have intellectual disabilities, and children with autism or other developmental disabilities sometimes spend days or even weeks in the emergency room waiting for treatment.

A mom of a 12-year-old girl spends the day on the phone calling provider after provider to find mental health support for her daughter. She can’t work, and she can’t sleep, and she panics nearly every minute of the day because her daughter, recently discharged from an in-patient hospital stay, remains profoundly depressed and at-risk. But mom can’t follow the immediate recommendation for outpatient care because everywhere she calls has a waiting list.

A grandfather is worried about his sixth-grade grandson, who is increasingly anxious at home and spending more and more time alone in his room. He reaches out to the school to see if they can set up time with the social worker but is told that, given the resources in the school, no one will be available to see the boy on a regular basis, and grandfather is told to call around in the community.

A dad calls the police for the third time in the month, because his 14-year-old son keeps leaving home late at night. Dad is worried that his son may be using marijuana and being taken advantage of by adults. He is scared something will happen to his son. He tries to stay awake to keep his son home, but too often he falls asleep in the chair and wakes up to find his son gone. He is desperate for help, but not sure where to turn.

An 11-year-old boy sits outside the principal’s office again, sent because of behavioral issues in class. He knows that mom has been sick and is overwhelmed at home. He is constantly bullied at school for his clothes and hygiene, but he doesn’t want the school to tell mom as she is in treatment and struggling to take care of everyone. He is supposed to be in therapy, but there is no one to take him and mom doesn’t want him on the bus by himself. He knows he is about to be suspended again and worries what he will tell his mom.

Children and their families are in crisis all over the state of Connecticut, all over the country. As the country’s Surgeon General stated in his urgent public health advisory issued this week, “The pandemic era’s unfathomable number of deaths, pervasive sense of fear, economic instability, and forced physical distancing from loved ones, friends, and communities have exacerbated the unprecedented stresses young people already faced.”

There is a need for immediate recognition of the chronic stress and trauma that so many children and adults are experiencing, and a courageous commitment to ensuring a healthcare system that reaches all children, and that addresses mental health support not as treatment for disease, not as a reaction to crisis, not as a carve out from “real” medical care, but as a necessary and undeniable predicate to wellbeing and development. We must answer the call issued for decades and shouted from the rooftops after Sandy Hook for meaningful and sustained investment in a mental health care system that reaches all, starts early, and never drops off.

The pandemic era’s unfathomable number of deaths, pervasive sense of fear, economic instability, and forced physical distancing from loved ones, friends, and communities have exacerbated the unprecedented stresses young people already faced. U.S. surgeon general

As the Surgeon General stated this week, “It would be a tragedy if we beat back one public health crisis only to allow another to grow in its place . . . Our obligation to act is not just medical – it’s moral.” To move forward we must also truly address the economic deprivation that plagues so many children and families.

What can we do next in Connecticut?

  1. We must prioritize helping children and youth, as the Surgeon General recommends, “[build] strong relationships with peers and supportive adults, practicing techniques to manage emotions, taking care of body and mind, being attentive to use of social media and technology, and seeking help when needed.”
  2. Connecticut must have a transparent and accountable plan for mental health care for all, integrated with schools and primary care, with an independent governance structure that relies on data to inform health care delivery, investments and recommendations to policy makers and insurance regulators.
  3. We must ensure that access to care is meaningful, and culturally competent, and can be found in schools, in community clinics, in primary care offices, and in people’s homes.
  4. We must enhance school based mental health care and ensure every district has a partnership with local mental health and social service providers, supported with federal and state healthcare and education dollars.
  5. We must urgently invest in our community non-profits who make up the bulk of our children’s mental health delivery system and are the ones delivering direct supports, including mobile crisis.
  6. We must require that mental health care is accessible to children with intellectual and other developmental disabilities.
  7. We must invest in our mental health care workforce, removing unnecessary barriers to licensure, offering educational payment support and loan forgiveness, and recognizing the inherent value in community health workers and other non-clinical professionals whose connection and partnership with people can be powerful and sustaining.
  8. No family should ever be alone with their questions, their fear, armed with only a list of numbers to call, praying someone on the other end of the phone will be able to help. Care coordination, case management, and peer support make a difference and must be accessible to all who need it.

We can’t just treat disease and pain. We must support children’s wellness from day one. We must make a real commitment as the Surgeon General’s Report states to “address the economic and social barriers that contribute to poor mental health for young people, families, and caregivers,” and meet children’s basic needs for affordable housing, equitable education, access to community activities and recreation, child-care and early childhood education, and support for adults in need. We must shift immediately from a focus on a return to business as usual and acknowledge and facilitate the healing and reconnection that must take place for our children, their peers, their educators, and their families.

We have long known that children who come to school hungry cannot learn, but children who start the day worried about themselves, their siblings, their parents and grandparents, cannot thrive. Deprivation is not an inevitable society ailment. As Nelson Mandela promised us, it can be overcome and eradicated by the actions of human beings.

State Child Advocate Sarah Eagan

Sarah Eagan, JD
Child Advocate
State of Connecticut

Alice Forrester

Alice Forrester, PhD
Chief Executive Officer
Clifford Beers Clini

The views, opinions, positions, or strategies expressed by the authors are theirs alone, and do not necessarily reflect the views, opinions, or positions of