Access, Not Barriers: What Families Really Need Right Now

This is the second piece in a two-part series on what families are really up against when it comes to mental health care. Part one was about stigma. This one’s about access—and I’ll be honest, I’m worried.

Mental health stigma is at risk of receding, but access? That’s going in the wrong direction. And no one seems to be shouting about it loud enough.

Instead of investing in evidence-based care and removing barriers, we’re watching those barriers pile up again—faster than we can clear them. The Mental Health Access landscape is looking more like a game of Whac-A-Mole, except these aren’t cartoon moles. They’re kids. They’re caregivers. And the fallout is real.

Here’s what’s keeping me up at night:

• Mental health funding is being cut. In schools. In communities. In programs that work. We’re pulling the rug out from under families just as they start to find their footing.
  
  
• Telehealth parity is under threat. Just a few years ago, we celebrated the fact that kids in rural areas or busy households could access therapy from their living rooms. Now, we’re questioning whether that access should continue. Why?
  
  
• Behavioral health is being treated as optional. Again. As if the idea of treating depression, anxiety, and trauma in kids isn’t essential to preventing chronic disease, substance use, or suicide later. It is.
  
  
• Medicaid enrollment instability. The one fallback for so many families? It’s in limbo. And that’s not just a paperwork problem—it’s a pipeline to care that may vanish overnight.
  
  
• Reimbursement rates are stagnant or falling. Which means providers are burning out or dropping out. And that leaves families scrambling—especially in under-resourced areas.
  
  
• Tariffs and supply chain disruptions are interfering with treatment access. That includes ingredients for medications and the means to administer them—injectables, capsules, you name it. It’s all connected.
  
  
• Workforce instability is leading to benefit losses. Layoffs and economic strain mean people are losing their employer-based insurance—and with it, their mental health care. There’s no parachute.
  
  
• Mental health is becoming a luxury. And let me be clear: it shouldn’t be. But when out-of-pocket costs rise and insurance options shrink, care becomes something only some families can afford.
  
  
• We're cutting research funding. The therapies we have today? They're not perfect. Progress depends on innovation. But we’re pulling back on discovery at the exact moment we need it most.
  
  
• Schools are losing their last lines of defense. When you cut school-based programs, you’re not just losing counselors. You’re losing the first adult who might notice something is wrong.
  
  

The snowball is already rolling. If you think we have a youth mental health crisis now—just wait.

I know this isn’t exactly feel-good content. But pretending everything’s fine doesn’t help families. Speaking plainly might.

And honestly, I think people in healthcare—especially behavioral health—are scared to speak up. Scared of saying the wrong thing. Scared of losing clients or being seen as political. Scared of sounding alarmist in a system that already feels like it’s fraying at the edges.

But here’s the reality: staying quiet won’t protect us. It just protects the status quo. And the status quo is failing our kids.

I can’t fix Washington. I can’t control the economy. But I can keep showing up for one child, one family, one clinician at a time. And I can keep pushing for systems that don’t force families into fighting to get basic care.

If you’re reading this and you feel the same, say something. Say it out loud. Say it in boardrooms, at school board meetings, in policy conversations. We cannot build a healthier future on silence.

We need better. We need braver. And we need it now.