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Children’s Mental Health Crisis in United States Demands Nationwide “System of Systems” Approach

Not-for-profit Calls for Whole-of-Nation Effort to Guide Investments and Address Issues Impacting Youth’s Mental Health

MCLEAN, Va., & BEDFORD, Mass., March 15, 2023—A “complete reimagination of the way we address mental health among our young people” is needed in the United States. The not-for-profit MITRE outlined a 14-point strategic vision and systemic approach that builds upon the efforts of federal agencies, states, and localities, as well as a broad range of investments in new and current programs, to address the country’s mental health crisis among our children and youth.

“If it isn’t already apparent in your own life experience, just ask your friends or extended family—the mental health crisis among today’s youth is real,” said Kim Warren, vice president and director of the CMS Alliance to Modernize Healthcare (Health FFRDC) at MITRE. “We see tremendous opportunity for federal, state, and local organizations to come together in a systematic, whole-of-nation approach to improve mental health outcomes for young people and their families.”

Researchers at MITRE cited the 2021 Centers for Disease Control and Prevention’s Adolescent Behaviors and Experiences Survey (ABES). This “first nationally representative look at the effects of the COVID-19 pandemic on the health of our nation’s youth” found 37.1% of students reported that they experienced poor mental health during the pandemic, and 31.1% experienced poor mental health during the 30 days preceding the survey. During the 12 months before the survey, 44.2% of the teens reported that they had experienced persistent feelings of sadness or hopelessness. The survey found that 9.0% attempted suicide and almost 20% considered attempting suicide.

“The time has come to bring together the wide range of stakeholders to rethink our approach to mental health for young people and to develop a new vision designed to respond to the crisis of children’s mental health,” said Cheryl Austein Casnoff, managing director, Healthcare Payment Innovation & Quality Division at MITRE, and a lead author of the analysis. “We’ve outlined opportunities to immediately begin to improve the impact of current investments as we move toward a more effective and equitable system that meets the mental health needs of our young people.”

Strategic Vision for an Improved System

MITRE identified 14 critical elements across four distinct themes for a re-envisioned mental health system for young people that advances wide-ranging calls to action through a review of current strategies, new investments, legislation, and consideration of key questions for stakeholders:

The Broad Vision and Principles

  1. Use a public health approach focusing on mental health promotion, prevention, early identification and intervention, treatment, and recovery supports.
  2. Elevate family and youth-driven care.
  3. Focus on equity.
  4. Address the social determinants of mental health.

How The Mental Health System Works

  1. Expand the workforce serving children and young people.
  2. Develop a comprehensive coordinated array of readily accessible services and supports.
  3. Build on technology as essential infrastructure and a mechanism to improve access and delivery of care.
  4. Ensure that timely innovations in mental health include a focus on children and young people.

The Funding and Payment Model

  1. Implement financing and payment systems to ensure a robust young people-focused benefit design.
  2. Align federal funding and policies to optimize a mental health system for young people.
  3. Re-establish an expectation in the Substance Abuse and Mental Health Services Administration (SAMHSA) Mental Health Block Grant that states submit a plan for children and young people’s mental health.

Evaluation and Accountability

  1. Establish data standards, quality, and accountability in prevention, clinical care, and system performance.
  2. Encourage a state governance structure for children and young people’s mental health.
  3. Designate a federal coordinator/unified plan for the behavioral health of young people.

For more information about MITRE’s “A Vision for Mental Health Systems of Care for Young People,” or to provide feedback, please contact

Editor’s Note:


MITRE’s mission-driven teams are dedicated to solving problems for a safer world. Through our public-private partnerships and federally funded R&D centers, we work across government and in partnership with industry to tackle challenges to the safety, stability, and well-being of our nation. Learn more at                                             

Media Contact: Mike Murphy,