Practical Strategies for Medicaid, Schools, Hospitals, and Communities
During Children’s Mental Health Awareness Week, May 3–9, and Mental Health Awareness Month, we are spotlighting actionable solutions across the US children’s behavioral health system. This post is intended for children’s behavioral health providers, state Medicaid agencies, school-based health centers, hospitals, local government agencies, local education agencies (LEAs), child welfare agencies, and philanthropic organizations that are working to strengthen prevention, crisis response, care coordination, and community-based continuums of care. HMA has a robust and growing team of behavioral health experts who support this work and have developed a series of case studies showcasing practical strategies implemented with clients—from crisis system design and referral pathway improvements to financing and implementation roadmaps.
Children’s Mental Health Awareness Week is a reminder that children’s behavioral health and youth mental health are not niche issues. They are systemic issues that require coordinated action across Medicaid, education, public health, hospitals and health systems, child welfare, and local government—especially where schools and community partners are on the front line.
The need remains substantial. The Centers for Disease Control and Prevention’s (CDC’s) 2023 Youth Risk Behavior Survey results, released in 2024, showed that 40% of high school students reported persistent feelings of sadness or hopelessness, even as some measures improved from 2021 levels. CDC also highlighted how bullying, safety concerns at school, racism, unfair discipline, and frequent social media use are tied to youth mental health risks.
The Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) 2024 National Survey on Drug Use and Health, released in 2025, adds another important dimension. Among adolescents ages 12–17, the 2024 survey found that:
- 15.4% experienced a major depressive episode within the past year
- 10.1% had serious thoughts of suicide
- About 40% who had a major depressive episode in the past year did not receive mental health treatment
The data show that progress is possible when systems respond with real capacity, access, and support. That is why this moment calls for more than awareness. It calls for action that is operational, financeable, and grounded in what works.
At HMA, we work with child-serving systems that are trying to solve real problems, including how to strengthen crisis response, improve referral pathways, build a more coherent continuum of care, and connect strategy with implementation.
Over the coming weeks, we will feature three examples that reflect different parts of the children’s behavioral health landscape.
1. Children’s hospital mental health strategy and crisis response
This case study will highlight work to help a children’s hospital strengthen its mental health approach and support next-stage crisis system design.
In this engagement, HMA partnered with Rady Children’s Hospital Orange County to move pediatric behavioral health from strategy to implementation—aligning emergency department (ED) mental health workflows, clarifying pediatric crisis pathways, building an investment-ready fiscal pro forma, and advancing priority programs to strengthen access and care coordination. This work can inform hospitals and health systems, Medicaid agencies, and community partners seeking to reduce ED boarding and improve pediatric crisis response.
2. County-level ecosystem and referral system improvement
This case study will show how local systems can bring multiple stakeholders together to improve referral pathways and make behavioral health more accessible for children, youth, and families.
HMA supported a county-led effort to strengthen cross-system referral pathways by aligning agencies around shared intake and triage practices, clearer roles and accountability, and more navigable access points for families. This approach is relevant for local government agencies, LEAs, school-based health centers, child welfare agencies, and community providers working to reduce fragmentation and speed connection to the right level of care.
3. Building a stronger children’s behavioral health continuum in New Orleans
This case study will focus on assessing gaps, identifying opportunities, and supporting a more coherent community-based continuum for children’s behavioral health.
HMA helped deliver the first integrated view of pediatric behavioral health in New Orleans, LA, aligning schools, healthcare, philanthropy, and government around a shared understanding of unmet needs and critical system gaps, as well as charting a prioritized roadmap to strengthen and better coordinate the continuum of care.
What It Means for Key Child-Serving Audiences
- Children’s behavioral health providers: Prepare for stronger care coordination expectations (warm handoffs, follow-up after crisis, shared care plans) and increased demand for community-based alternatives to the ED
- State Medicaid agencies: Focus on financeable crisis continuums (including pediatric crisis response), payment and contracting approaches that support access and continuity, and data/reporting that demonstrates outcomes
- School-based health centers and LEAs: Strengthen referral pathways, clarify roles between schools and providers, and build protocols that support early identification while keeping students connected to safe learning environments
- Hospitals and health systems: Improve pediatric ED mental health workflows, create clearer crisis pathways, and develop investment-ready business cases for behavioral health capacity and partnerships
- Local government agencies: Convene cross-system partners, establish shared intake/triage and accountability, and use implementation roadmaps to move from planning to operational change
- Child welfare agencies: Align behavioral health access for children and youth involved with child welfare, reduce handoff failures, and integrate crisis planning into placement stability and permanency strategies
- Philanthropy: Target catalytic investments that fill continuum gaps, build capacity for implementation (not just planning), and support cross-system governance and measurement
The common thread among these examples is a simple belief: Children’s behavioral health improvement does not happen through aspiration alone. It happens when organizations and public systems translate urgency into design, partnerships, financing strategies, and implementation steps.
That is also why children’s behavioral health is so relevant. National data still point to high levels of distress and suicide risk among adolescents, despite recent improvements. CDC’s findings show how strongly youth mental health is shaped by the environments in which they live, learn, and play—especially their schools and communities.
For leaders in Medicaid, behavioral health, child welfare, education, county government, hospitals, and provider organizations, the question is not whether children’s behavioral health deserves attention, but rather is how to build systems that respond earlier, coordinate better, and support children and families more effectively.
We hope this series contributes to that conversation by sharing practical examples of work that can inform future action.
Other Resources on Children’s Behavioral Health and Youth Mental Health
- Children’s Behavioral Health Consulting: Cross‑System Solutions for Schools, Health Systems, and State & Local Agencies
- Improving Youth Behavioral Health Through School-Based Initiatives.
- Beyond the Agency: A Public Health Approach to Child Welfare
- MAHA Children’s Health Strategy Report: Driving a New Era for Child Health Policy
- Child and Teen Mental Health and the Lifting Voices initiative
- HMA Report: Los Angeles County Child Welfare-Involved Population Medi-Cal Analysis
- Webinar Replay – Youth mental health access: school-based intervention strategies
Contact us to discuss how HMA can support your children’s behavioral health strategy—whether you work for a Medicaid agency, hospital/health system, school-based health partner, LEA, local government agency, child welfare agency, provider organization, or philanthropic funder. We can help with crisis continuum planning, care coordination design, referral pathway improvement, financing and pro forma development, and implementation support.
