Untapped Potential: Digital Therapeutics for Children’s Mental Health Remain Largely Unaccessible

A groundbreaking solution for children’s mental health – clinically validated digital therapeutics like the FDA-cleared video game EndeavorRx – is being drastically underutilized, leaving countless families struggling with limited options. Despite a soaring pediatric mental health crisis and a growing recognition of the need for non-pharmaceutical interventions, systemic barriers to access and reimbursement continue to hinder widespread adoption.

The disconnect is particularly stark given the success of virtual reality (VR) therapy within the Veterans Health Administration (VHA), where immersive technology is now routinely used to treat a wide range of conditions. If these innovative treatments are deemed effective for our veterans, why aren’t they readily available to the children who desperately need them?

The Pediatric Mental Health Crisis: A Nation in Distress

The statistics paint a grim picture. One in five American children currently lives with a mental health condition, a number that continues to rise. Rates of teenage depression have nearly doubled since 2009, and tragically, suicide is now the second leading cause of death among adolescents. Four years after pediatricians declared a national emergency in children’s mental health, emergency departments remain overwhelmed with young people in psychiatric crisis.

Historically, the default response has been pharmacological intervention. American children are prescribed psychiatric drugs at a higher rate than their counterparts in any other developed nation. However, a recent report from the MAHA Commission identified this as a “crisis of overdiagnosis and overtreatment,” a rare point of bipartisan consensus. The current system often prioritizes medication not because it’s the optimal solution, but because it’s the only one consistently covered by insurance.

Digital Therapeutics: A New Paradigm in Pediatric Care

Fortunately, the landscape is beginning to shift. Digital therapeutics – software-based treatments validated through clinical trials and cleared by the FDA – offer a promising alternative. Virtual reality neurotherapy, for example, provides children with a distraction-free environment to practice essential cognitive skills like sustained attention, working memory, and impulse control, guided by exercises designed by neuropsychologists. These therapies have demonstrated significant improvements in cognitive function without the adherence challenges associated with medication or traditional therapy.

The versatility of digital therapeutics is a key advantage. A single VR headset can deliver targeted interventions for a multitude of conditions, including ADHD, anxiety, and autism. Advanced systems now incorporate artificial intelligence, personalizing each session based on the child’s unique symptoms, responses, and social context while maintaining the standardization required for insurance coverage.

Research supports the efficacy of these interventions. A 2025 systematic review of fourteen studies revealed that VR interventions improve social skills in children with autism. Separate research indicates that VR-based interventions enhance sustained attention in children with ADHD, leading to increased accuracy and reduced errors. The FDA has already cleared nearly twenty prescription digital therapeutics, signaling a growing acceptance of this innovative approach.

The infrastructure for widespread implementation already exists, largely thanks to the VHA’s pioneering efforts. The VA’s success demonstrates that immersive therapy can be seamlessly integrated into existing healthcare systems, with clinicians effectively trained, patients actively engaged, and ultimately, improved outcomes achieved.

The Reimbursement Hurdle: Why Aren’t Children Benefitting?

Despite the compelling evidence and proven infrastructure, access to digital therapeutics for children remains limited due to reimbursement challenges. Medicare and Medicaid currently do not cover these treatments, and consequently, neither do most private insurers. The Congressional Budget Office even struggled to assess the potential cost of the Access to Prescription Digital Therapeutics Act, highlighting the lack of precedent for reimbursing such interventions.

Germany, in contrast, has been reimbursing digital therapeutics since 2020, investing €234 million and currently covering over fifty products.

However, momentum is building in the United States. The recent announcement of the $50 billion Rural Health Transformation Program by the Centers for Medicare & Medicaid Services (CMS) represents the largest federal investment in rural healthcare in decades. This program explicitly prioritizes “innovative technologies that promote efficient care delivery” and “access to digital health tools,” aiming to reach the sixty million Americans living in rural communities with limited access to mental health services.

Furthermore, the reintroduction of the Access to Prescription Digital Therapeutics Act in the Senate, with bipartisan support, seeks to establish Medicare and Medicaid coverage for FDA-cleared software treatments. Advocates are leveraging Germany’s spending data to address budgetary concerns that have stalled previous iterations of the bill.

What’s different now is the clear demonstration of success within the VA system. We can now confidently ask: if VR therapy is beneficial for our veterans, why shouldn’t it be equally accessible to our children?

Do you believe that insurance companies should prioritize coverage for digital therapeutics, even if it means reallocating funds from other areas of healthcare? What role should parents play in advocating for access to these innovative treatments for their children?

Frequently Asked Questions About Digital Therapeutics for Children