5 Trends in Children’s Behavioral Health in 2025
By Ellen Hallsworth, Director, Bradley REACH, Bradley Hospital
“Tackling other root causes of poor mental health, from poverty and food insecurity to gun violence will also likely be key, if we are to move upstream and not just tackle the mental health crisis in front of us, but prevent it in future generations.”
2025 marks five years since the COVID-19 pandemic created unprecedented demand for children’s behavioral health and catalyzed huge changes in care delivery. Halfway through the decade, the world of telehealth, licensure compacts and mental health apps is dramatically different.
Looking to the future, here are five trends that are likely to define behavioral health for children and families over the coming year and beyond.
Financing
2025 could be a perfect storm for behavioral health reimbursement.
First, Medicaid. Anecdotally, as many as 70% of pediatric behavioral health patients regionally are Medicaid beneficiaries. The detail of the incoming Trump administration’s plans for the future of Medicaid remains unclear, but the thrust towards cutting federal Medicaid spending is obvious. States in New England that have worked to increase Medicaid funding for behavioral health in recent years (including the MassHealth and HUSKY rate increases) may struggle to protect the gains made. At a time when many health care providers in our region are already struggling financially, the implications of cuts could be enormous, affecting both providers and access to care for patients.
Second, recent years have seen a boom in federal funding for behavioral health in schools. The funding has led to an increase in mental health clinicians in schools, and innovative service delivery that “blends and braids” insurance and grant funding. That funding expired in late 2024; states had to allocate all funding by the end of the year. Mental health has long been over-reliant on grant funding and for that reason has struggled with sustainability. This time is likely to be especially challenging.
We’ll deal with these issues in more depth in our event “Beyond the Funding Cliff” in February [insert link].
AI
When ChatGPT released to the public in late 2022, there was a sense that it might change things in health care delivery at some point beyond the horizon. Just over two years later, we are beyond that horizon. From screening for risk through suicide monitoring software, managing patient intake, helping clinicians with notetaking and even delivering care, this year will likely be a tipping point for how embedded AI is in care delivery. Given the ongoing workforce shortage, there is huge opportunity if AI means that clinical staff can be used more effectively. Getting there will likely require reassurance in the face of safety concerns and a confusing regulatory landscape that may slow innovation.
Quality
A few years ago, emergency rooms across the region were swamped on a daily basis with dozens of pediatric “boarders” waiting for inpatient beds, often for days or even weeks. At that point, increasing access to care was a major focus. Now that most emergency rooms may only have a few patients waiting for treatment on any given day, the quality of behavioral health care has emerged as a priority. As digital health solutions proliferate and compete both for limited reimbursement and patient attention, understanding what care works and for whom is going to be increasingly important. Increased use of measurement-based care [see our forthcoming webinar – insert details] is going to be key to demonstrating quality. Greater specialization is likely to be a key aspect of driving quality – it’s been well-known for years in surgery that surgeons who perform procedures most frequently have the best outcomes – is the same true of behavioral health?
Community-based care
Residential programs for children and adolescents have come under increasing scrutiny over the past year, especially in the Senate Finance Committee’s devastating Warehouses of Neglect report, alleging serious physical and sexual abuse at many facilities. In Rhode Island, concerns have also emerged about over-hospitalization of children with intellectual and developmental disabilities. This is likely to lead to renewed focus on delivering care close to home, even at fairly acute levels. Intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs) may be part of the solution.
A public health approach
Prevention is better than cure. Increasingly, behavioral health is seen as a societal rather than a personal issue. Australia’s recent ban on social media for under 16s is just one example. Whether it’s enforceable and whether US states try to follow suit remains to be seen. Tackling other root causes of poor mental health, from poverty and food insecurity to gun violence will also likely be key, if we are to move upstream and not just tackle the mental health crisis in front of us, but prevent it in future generations.
What have we missed? Are there unexpected forces that might reshape behavioral health for children and families? What issues could especially benefit from a regional and cross-sector approach? Contact us and let us know at info@necbhn.org.
