Community Health Needs Assessment Theme 7: Long Delays and Discontinuity Are Harmful.
The seventh theme that emerged from our 2025 community health needs assessment is that delays in care and discontinuity in services are harmful. Adults and youth struggle to navigate healthcare and social service systems. Parents feel they are competing (with other families) just to be waitlisted for diagnostic and therapy services, and believe these delays harm their children. Providers and educators concur, and they see how delays derail social, emotional, and academic development. Representatives of immigrant and minority communities report that delays are longer when non-English speaking providers are needed.
Long delays and service disruptions stem from three main sources: IEP/504 process; workforce shortages; and workforce turnover.
In our 2025 community health needs assessment, we heard 10 major themes impacting youth mental and behavioral health in St. Louis County. See them all and learn how we conducted this assessment.
IEP/504 Process.
Where educators describe a regulated, data-driven process for IEP/504 eligibility verification, parents see rigidity and believe the complicated system is designed to delay or withhold help that their children need. Stories about long waits for appointments to see an educational psychologist (or another mental health professional) for diagnostic evaluation are common.
Workforce Shortage.
Most community health needs assessment participants point to the national/regional workforce shortage in mental and behavioral health specialists as the reason for poor access to diagnostic services. Parents report no complaints about referrals or diagnostic services available from established primary medical care providers (e.g. pediatrician), however, long delays in seeing new specialists (e.g., child psychiatrists) are common.
Workforce Turnover.
Workforce turnover occurs when a therapist (or other mental healthcare professional) leaves their job. And, when this happens at school, educators report the classroom is disrupted as the teacher directs more attention to the affected child(ren). Furthermore, they say service discontinuity may feel like abandonment to a child with a history of serious trauma, further exacerbating problematic behaviors.
While the cause of workforce turnover is complex, some participants believe low wages drive the frequent switching to higher-paying jobs. Other participants see corporate culture and leadership as more important, noting burnout is lower at agencies with reasonable caseloads and more support for trainees.
We spoke to more than 300 St. Louisans to understand what needs exist when it comes to youth behavioral health. Learn more about our process.