RESUMO
In the context of the current youth mental health crisis, it is prudent to reconsider how resources are allocated to facilitate the delivery of effective and comprehensive supports and services to children and adolescents. Schools are the main delivery sites for youth mental health services. Many districts have adopted comprehensive school mental health systems (CSMHS) to provide a multitiered approach comprising mental health promotion, prevention, and intervention to students via partnerships between school and community health and behavioral health providers. COVID-19 relief funding and other new federal and state investments in school mental health have led to expansions of school mental health programming in most states. An impending federal funding cliff necessitates an examination of how to wisely invest now to achieve the greatest positive future impact on youth mental health. To capitalize on opportunities to sustain effective school mental health and maximize return on investment, states may consider four strategies: leverage cross-sector partnerships to advance school mental health policies and funding, strengthen and expand Medicaid coverage of CSMHS, establish and enhance data systems, and create state technical assistance and professional development support for CSMHS implementation through local education agencies.
Assuntos
COVID-19 , Serviços de Saúde Mental Escolar , Humanos , Estados Unidos , Criança , COVID-19/prevenção & controle , COVID-19/economia , Financiamento Governamental , Adolescente , Governo Estadual , Medicaid/economia , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Escolar/economia , Serviços de Saúde Escolar/organização & administraçãoRESUMO
En el presente trabajo se analizan los antecedentes con respecto al gasto público en salud poniendo énfasis en su evolución, comportamiento pro-cíclico y su caracter redistributivo. A continuación se estudian el proceso de privatización de la salud y el traspaso de su costo a los usuarios, tratando de identificar los mecanismos a través de los cuales las reformas implementadas en el área de la salud ha tendido a producir una mayor segmentación en la calidad de las atenciones y prestaciones que reciben los chilenos según su nivel de ingresos. Finalmente, se analizan los programas de salud implementados y sus resultados. Nos centramos en el impacto de la política de salud y nutricional sobre: a) los escolares, jóvenes y adolescentes, grupo particularmente desatendidos por los programas públicos y, b) el sector materno infantil, grupo definido como prioritario por las autoridades del sector salud. El análisis y los antecedentes presentados a lo largo de todo el trabajo se refieren al periodo 1974-1986 en que se han producido importantes cambios estructurales en el área salud