Behavioral Health Programs for At-Risk NH Youth


Lisa K. Madden, MSW, is president and CEO of Riverbend Community Mental Health.

The American Academy of Pediatricians, the Children’s Hospital Association, and the American Academy of Child and Adolescent Psychiatry recently declared children’s mental health a national emergency. The American Psychological Association added that children’s mental health is in crisis.

Yet in March, NH House approved HB 1639, relating to the Youth Risk Behavior Survey (YRBS) in schools, despite objections from educators, students and child advocates, health centers mental and community health and substance use disorder providers. .

This legislation will make the annual YRBS an opt-in rather than an opt-out, making it more difficult to gather information and identify trends. It will also mean that New Hampshire could lose significant funding for direct behavioral health care services for our youth, by limiting access to the data needed to inform policies and programs.

YRBS was developed by the US Centers for Disease Control and Prevention (CDC) and is deliberately structured as an opt-out program to maximize participation and expand data collection as widely as possible. Studies show that the data collected is valid and reliable, with safeguards in place to rule out false responses; and all data is aggregated before it becomes publicly available, so it cannot be linked to any individual.

State health and education officials use this anonymized data to track trends and develop health systems and policies that prevent and treat risky and unhealthy behaviors in high school students.

Particularly in the age of COVID, it is essential to recognize any changes in student behavioral health patterns so that schools, parents, and programs can adjust their strategies to support young people accordingly.

The CDC recently completed a national survey of more than 7,700 high school students. They found that a third said they had suffered from stress, anxiety or depression during the COVID-19 pandemic. Almost a fifth said they were seriously considering suicide. Now, perhaps more than ever, we need data to help inform us about what matters to our young people and how to help them. Moving YRBS to opt-in would significantly reduce survey participation, reduce the amount of data collected, and weaken prevention and treatment programs that rely on that data.

NAMI New Hampshire (the National Alliance on Mental Illness), a local nonprofit agency that provides support, education and advocacy for individuals, families and communities affected by mental illness and suicide, has used YRBS data to successfully apply for a needed youth suicide prevention grant from SAMHSA.

These funds are distributed to project partners – community mental health centers, such as Riverbend Community Mental Health in Concord, regional public health networks, community colleges and other New Hampshire providers – to fund targeted suicide prevention efforts among young people and adults in transition.

YRBS data was essential in leveraging the current $3.675 million 5-year grant and in determining the scope of the project. The proposed move to make the YRBS an optional survey will produce significantly less data, which will ultimately impact New Hampshire’s ability to secure future funding and ensure interventions appropriately target our most vulnerable youth. .

HB 1639 falls into the same category as a number of pieces of legislation we have seen in 2022 that focus on parental rights, whether in education, health care or mental health. Lawmakers and citizens who oppose vaccines, mandatory masks, public education and public health argue that parents know what is best for their children and that the state (the “bureaucrats” in particular) should not have a say.

There is no doubt that parents must be the main voice, but let us remember that our young people must also have a voice! They are the ones who suffer, use substances to manage anxiety, consider harming themselves, see their friends suffer, and they are the ones who participate in Active Shooter Drills just in case the rage of a distraught classmate would wreak havoc on their school.

They should have a voice to say what it’s like to be them. It is these vulnerable children who will be most affected if HB 1639 becomes law and funding for programs such as NAMI’s suicide prevention grants is lost.

The State Senate must carefully consider the programs that will disappear if HB 1639 is enacted and consider whether it is worth creating an opt-in that will effectively deny New Hampshire funding for behavioral health services .

It is dishonest to lament the mental health, addiction, opioid, suicide, and domestic violence issues that continue to plague our beautiful state simply because an opt-in looks like “freedom.” For all the kids with untreated behavioral health issues, that’s no kind of freedom. They deserve to have a voice; the YRBS is the tool to share their message.


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