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Home > Policy
Overview
The TeenScreen National Center operates an active federal and state policy effort to encourage the adoption of promising approaches to the early identification of mental illness by working closely with government and advocates, supporting demonstration projects, and collaborating with expert panels. The TeenScreen National Center serves as a resource for members of Congress and their staff, state legislators, federal agencies, state health and Medicaid commissioners, and state suicide prevention offices. Read about a Congressional Hill Briefing led by the TeenScreen National Center.
Science to Service
Since the mid-1990s, Columbia University has been at the forefront of new research on the effectiveness of mental health screening. In 2009, the strength of the evidence was recognized by an Institute of Medicine Report calling for the early identification and prevention of mental illness in youth. Soon after, the U.S. Preventive Services Task Force (USPSTF) recommended annual screening for depression for all adolescents ages 12 to 18 when systems are in place to ensure accurate diagnosis and follow-up. The TeenScreen National Center is working with policymakers, administrators and health plans to develop best practices to implement these recommendations and guidelines. Read more.
The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008
MHPAEA was signed into law in 2008. This law provides federal parity protections to ensure that mental health and substance use disorder benefits are on par with medical and surgical benefits. View the legislation.
After the law was signed by President Bush, the Departments of Treasury, Labor and Health and Human Services were tasked with issuing regulatory guidance. Before issuing regulations, the Departments considered public comments. The TeenScreen National Center submitted comments urging the Departments to ensure that parity would extend coverage for mental health screening. Read more.
Interim final regulations that clarify how the parity protections will apply were issued on February 2, 2010 and are available here. These regulations did not address how mental health parity applies to scope of services in great detail, and the Departments requested additional public comment. While supportive of the initial regulations issued by the Departments, the TeenScreen National Center did submit comments urging greater clarity with regard to how parity applies to scope of services. The public comment period closed on May 3, 2010, and final regulations are expected within the next several months.
Health Care Reform
The federal health care reform bills that were signed into law in 2010 will expand access to care; provide new consumer protections for privately purchased health care; and spur innovation in health care payment, quality and delivery practices. The law also will extend mental health parity protections to new groups of covered individuals, and it will directly affect mental health screening by mandating access to certain preventive services at no cost. Read more.
Preventive Services Covered under the Affordable Care Act - New resources on www.heathcare.gov explain the importance of preventive care and list the recommended preventive services to be offered without cost-sharing under the health care reform law.
Medicaid
The annual well-child checkup covered by Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit requires that an adolescent mental health assessment be offered during the visit. Evidence suggests that few states require mental health checkups as a regular part of the covered well-child visit. The TeenScreen National Center offers policy options at the Federal level to improve state practice. Read more.
Among U.S. states, Massachusetts has some of the most comprehensive requirements for the inclusion of mental health screenings in EPSDT primary care visits. Other states can use this experience as a model for expanded mental health screenings through EPSDT. Read more.
Quality
As the experience in the Medicaid program demonstrates, defining mental health screening as a covered benefit is not always sufficient to ensure that it is provided in clinical practice. Quality measures, such as those proposed by the Children’s Health Insurance Program Reauthorization (CHIPRA) legislation, can help to improve both recognition of the need to provide this service and the rate at which it is offered. Read more.
Fact Sheets
Fact sheets are available on a variety of policy-related topics:
Federal and State Suicide Prevention Programs
The TeenScreen National Center informed the design of the nation’s first national suicide prevention legislation, the Garrett Lee Smith Memorial Act. Local TeenScreen sites are helping to implement federal suicide prevention efforts. At the state level, 44 states have suicide prevention plans in place that mention screening as a key method of early identification and prevention. Nine of these states specifically endorse the use of local TeenScreen programs in: New York, Florida, Iowa, Nebraska, New Mexico, Oregon, Vermont, Delaware and Montana.
- TeenScreen and the Garrett Lee Smith Memorial Act. Read more.
- State Suicide Prevention Programs. Read more.
Policy Partners
Seven of the nation’s leading mental health organizations, and more than 20 professional groups, endorse mental health checkups for every young American. Read more.
Advocate
Health providers, policymakers, school professionals, parents and other members of the community can support mental health checkups for youth. Opportunities to educate lawmakers and members of the community to build support, as well as resources to start screening in your community are available. Read more.
Get Involved and Get More Information
Contact: TSPolicy@childpsych.columbia.edu
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