Today’s blog launches our new series on Best Practices for Children and Youth Behavioral Health. In this first installment, we explore what’s often considered the gold standard for supporting the behavioral health of children and youth.
Three leading experts – ABHW board members Dr. Caroline Carney, President and CEO of Magellan Health; Dr. Deborah Fernandez-Turner, Deputy Chief Psychiatric Officer at Aetna, A CVS Health Company; and Dr. Doug Nemecek, Chief Medical Officer at Evernorth – share their perspectives on early identification, effective treatment, support systems, and ongoing care. Their insights shed light on the evidence-based approaches that can help families access the right support at the right time.
In your view, what is considered the evidence-based approach for treating children and youth behavioral health today?
- DOUG: Evidence-based care for behavioral health conditions is considered best-practice, and starts with clinical practice guidelines that are rooted in rigorous research and have been shown to improve long-term outcomes. These guidelines give us the structure for treatment plans, but we also want to allow flexibility for individualized care. Evidence-based care practices include incorporating behavioral health screenings into pediatric, school, and community settings because the earlier we can identify a concern, the better the long-term outcome will be for the child. Prevention strategies have strong evidence and are essential parts of a comprehensive approach.
- DEBORAH: When we talk about evidence-based approaches today, I think first about prevention through early identification of behavioral health needs. Screenings allow us to pick up on behavioral health needs before they escalate, and a vast amount of evidence shows that early intervention changes lives. Clinical practice guidelines, which are grounded in extensive research that leads to improved outcomes, help ensure that, once identified, children and youth are receiving treatments proven to work rather than untested approaches. Combining those guidelines with coordinated care, such as with family members and schools, gives us the best chance to support both immediate needs and long-term well-being.
- CAROLINE: The evidence tells us that the most effective way to support children’s behavioral health is to take a comprehensive approach: follow clinical practice guidelines, which have been demonstrated to improve outcomes, for treatment; use screening tools for early detection; and build in prevention strategies that address any risks. We know interventions like school-based prevention programs, trauma-informed care, family supports, and home and community-based supports have measurable benefits. When we bring those together, we’re not only treating behavioral health needs and addressing social needs, but we’re also building resilience and preventing future crises.
How important is early identification in setting the foundation for effective treatment?
- CAROLINE: Early identification is critical in setting the foundation for effective treatment and long-term wellbeing. When we use screening tools, we can recognize behavioral health concerns, sometimes before symptoms become severe, and intervene in ways that prevent long-term challenges. We also know from decades of research on Adverse Childhood Experiences (ACEs) that the impact of trauma and stress in childhood can carry over into adulthood, affecting not just mental health, but also physical health outcomes. By screening early and connecting children and families with evidence-based supports, we can mitigate those risks, promote resilience, and change the trajectory of a child’s health and wellbeing. Prevention and early intervention aren’t just helpful; they’re essential.
What role does family involvement play in evidence-based behavioral health care for children and youth?
- DEBORAH: Family involvement is central to evidence-based behavioral health care for children and youth. Research shows that outcomes improve when caregivers are actively engaged, for example, through reinforcing skills at home or partnering with providers to set goals and monitor progress. Children don’t exist in isolation; their families and home environment shape their development, coping skills, and recovery. When families are supported and included, treatment is more consistent, practical, and sustainable, which are critical for long-term success.
How can schools and pediatricians be integrated into a “gold standard” approach?
- DEBORAH: Schools and pediatricians are often among the first to notice when a child is struggling, so bringing them into the care process is essential. A gold standard approach means creating a coordinated system where schools, pediatricians, and behavioral health providers share information, use common screening tools, and align around evidence-based practices. Schools can support prevention and early intervention, while pediatricians can help identify concerns during routine visits and connect families to specialized care. When schools, pediatricians, and behavioral health providers work together, children receive support earlier, families feel less isolated, and treatment is more effective and sustained.
What supports should be in place after treatment to help children and families to manage behavioral health and sustain progress?
- DOUG: Research completed in 2024 by our Evernorth Research Institute showed that despite seeing a 28% increase in the number of youth who received a behavioral health diagnosis in the 5 years over the pandemic, 38% of these youth did not receive any behavioral health treatment within 6 months of receiving their diagnosis. Children and their families need ongoing supports, such as regular follow-up care, access to peer and family support groups, and coordination with schools and community resources. Parents and care-givers can benefit from coaching and support, too. Skills-building at home, like practicing coping strategies, helps children apply what they learned and set them up for long-term success. When families have consistent check-ins, clear pathways back to care if symptoms return, and a strong community network, children are much more likely to maintain gains and thrive long-term.
