Every statistic supports what we already know—our youth mental health crisis is getting worse. These numbers will improve when we increase preventative care access.

When we catch problems early, we can prevent the crises that threaten our kids’ health and development, and overburden our workforce. Unfortunately, preventative care is not always provided because of patient cost barriers and the stigma around mental health.

To help alleviate these challenges, the Center of Excellence for Integrated care is developing a policy that would allow children ages 0-17 to have a free annual mental health wellness visit. All insurers in North Carolina would cover the costs of this visit, just like they currently do for well-child visit exams.

North Carolina youth who have had at least one major depressive episode in the past year has DOUBLED from 8% in 2015 to 17% in 2022.

22% of high school students—and 48% of LGBTQ students—have contemplated suicide in the last 12 months.

In 2020, suicide was the leading cause of death for North Carolina children ages 10-17—with suicide rates increasing over the past decade.

At a child’s annual well-visit appointment, the child and/or caregiver completes a questionnaire or “screener” to find potential socio-emotional/mental health concerns.

What changes when a mental health wellness service is available?

This policy aims to protect North Carolina’s health care workforce by putting more emphasis on prevention. It will help lower the number of children facing mental health crises and decrease the provider time needed to treat them. Well-visits will remain optional and based on availability of services. By prioritizing wellness, it will also help burnout among clinicians.

Many different practitioners with mental health experience can conduct well-visits.

Licensed Physician or Physician Assistant (PA)
Advanced Practice Registered Nurse (APRN)
Licensed Clinical Social Worker (LCSW) or Associate (LCSWA)
Licensed Marriage and Family Therapist (LMFT) or Associate (LMFTA)
Licensed Professional Counselor (LPC) or Associate (LPCA)
Licensed Clinical Mental Health Counselor (LCMHC) or Associate (LCMHCA)
Licensed Psychologist (LP) or Psychological Associate (LPA)

The Mental Health Well-Visit Process

If a mental health concern IS identified

If a mental health concern IS NOT identified

The proposed policy changes what occurs next. This is when a mental health well-visit would be initiated.

Depending on clinic resources, and with caregiver consent, a mental health well-child visit can be provided on the same day, through a referral to an outpatient licensed clinician, or via telehealth services. The PCP introduction emphasizes the importance of whole-person care and the value of participating in a brief behavioral health appointment.

Mental health well-child visit content includes developing age-appropriate coping skills such as:

Learning resilience strategies
Building healthy relationships
Strengthening social connections
Reducing stress
Mindfulness
Getting quality sleep

Providing this service annually introduces and de-stigmatizes conversations around mental health and therapists so the benchmark for seeking assistance is not a mental health crisis.

Our Vision: Protecting Our Children's Mental Health

Envision having access to preventive mental health care since birth—building a strong foundation of health care that accounts for the whole-person, including mental health wellness.

Meet Alex—as he navigates his first year away from home at college, he reflects on his ups and downs, and the benefits of preventive mental health care. We must give the same degree of attention, importance, and infrastructure to maintaining our mental health as we do our physical health.

Mental Health Well-Visit Resources

Protect Our Children's Mental Health
Mental Health Well-Visit Outline
Similar mental health well-visit policies in other states

Ready to find out more?

Contact us for more information or to provide feedback on this important policy.

The mission of the Center of Excellence for Integrated Care is to enhance whole person health care across North Carolina through workforce development, practice transformation, and advocacy.

Policy

Protecting our children’s mental health by expanding access to preventative care.