An increasing number of children have faced mental health problems since the start of the pandemic. The American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association declared a national state of emergency for children’s mental health in October 2021.
Twin Cities hospitals continued to see an increase in patients. During the first year of the pandemic, M Health Fairview saw a 46% increase in children seeking help with a mental health crisis in its emergency rooms. From this year to today, demand has grown by 16.6% in emergency departments compared to 2021.
“I think it is very clear that we are in a mental health crisis for young people,” said Jamie Winter, director of mental health services at Children’s Minnesota. “Over the past year, we have seen a sharp increase in the number of children who have entered our two emergency wards seeking acute mental health care, with thoughts of suicide or attempted suicide, and who really need the highest level. of assistance in our hospitals. “
Children’s Minnesota has seen a 30% increase in patients in its emergency wards in 2021 compared to 2020, a trend that continues. In 2021, suicide ideation became one of the top five diagnoses in pediatric hospitals.
“I think the thing we keep hearing from families and children is how difficult the past two years have been,” said Winter. “Access to mental health services is difficult throughout the subway, throughout our state and therefore they don’t always get the care they need when they need it upstream to avoid having to visit us in the emergency room.”
For some families, there may also be difficulties in accessing care once they have visited the emergency room. Health systems have raised concerns about a shortage of inpatient mental health beds across the state.
“All systems in our Twin Cities metropolitan area are overwhelmed by their own demand and children in their own emergency wards are in need of care and so often there may not be beds available,” said Winter. “Babies can sit and wait with us for hours, days, even up to a week when they’re really just waiting and they’re in limbo, where they have to go to a mental health shelter but there’s no bed available. “
Waiting in an emergency room for an inpatient bed to open is known as “boarding”. 5 EYEWITNESS NEWS first reported increasing waiting times in 2021.
When Elk River’s mother Lauren Bialon discovered chat messages between her then 12-year-old daughter and a group of other girls at school detailing plans to end their lives, she took her daughter to Mercy Hospital. .
“We took it knowing it was in crisis,” said Bialon. “They brought Caley back to their triage room immediately and did the initial hiring of him pretty quickly.”
She explained that her daughter spent most of her two and a half days in hospital in the emergency room due to a shortage of mental health beds.
“It was a bit of a shock to us,” Bialon said. “Out on the main emergency room floor, a child can go straight out of that room.”
On the second day of her daughter’s admission, as the hospital worked with them to locate an acute care bed, Bialon said the care team offered to send them home with medication. Bialon told 5 EYEWITNESS NEWS that they didn’t consider it a safe option.
At the same time, they were also contacting treatment centers across the country, including a wilderness option.
“For two days there were no beds available in the state of Minnesota, so we were looking for places in Wisconsin, North Dakota, five hours away just to get stabilized,” he said. “We were reaching our point of what are we going to do next? Do we take Caley home and wait for the wilderness to call us back? What are we doing in Caley these days? It doesn’t bode well for her to sit here doing nothing either.
About two and a half days after her hospitalization, Bialon said she received a call from the hospital that she had found an inpatient bed for her daughter.
“We went ahead and decided that Caley would go on with that placement because we knew that if she got home, there would be no chance for her to stay safe,” he said.
According to Allina Health, visits to the pediatric emergency room for mental health reasons have decreased. The hospital recorded 3,685 visits in 2021 compared to 3,784 in 2020. So far in 2022 there have been 2,583 visits.
“Emergency rooms have been a little quieter at this time this summer,” said Dr. Mary Beth Lardizabal, director of the child and adolescent psychiatric services system at Allina Health. “Before the summer, the numbers were really high and we would have had a large number of retired children as well as children who could remain in the [emergency department] for hours or days “.
He added: “As we see the school start to grow, will we start to see more children go to the emergency room? We are working hard to find ways to get the children out of the emergency room to prevent them from having to go to the inpatient units.
He explained that they are developing their own partial hospitalization programs, which allow children to receive care during the day but sleep in their own beds at night.
“We are increasing the number of places in those programs by 30% and we are putting those partial programs in regional areas like Faribault or Cambridge or Hastings, where they don’t have as many psychiatric services,” said Dr. Lardizabal.
Although the data showed some improvement in the number of children seeking care in Allina’s emergency wards this year, Dr. Lardizabal is cautious.
“There are actually fewer children coming to the ER this year and our number in the outpatient world has been pretty stable, and that doesn’t fit with the things we know, which is that there is a greater need,” she said. . “What I was wondering and worried a little bit is that the children are not getting the care they need, are they literally waiting to receive services and cannot enter? From Allina’s point of view, we have been very busy, very full but we don’t have enough providers, we don’t have enough therapists, so my concern is that the children are not getting the care they need.
Last week, Allina announced plans to open a new center on the Mercy Hospital-Unity campus as well. The center will provide partial in-patient mental health services for children, as well as addiction and adult programs.
According to Allina, several partnerships will be co-located at the center to also provide services such as food assistance.
“The specialty center is truly set up to address so many other factors for patient health, including the social determinants of mental health,” said Dr. Lardizabal.
Minnesota Children’s, meanwhile, plans to open a new inpatient unit in November. It will have 22 beds and should serve about a thousand children a year.
“There are a lot of barriers to getting that definitive placement of inpatient mental health care and so we really hope to simplify and really reduce some of those barriers,” Winter said. “We often see not only problems with bed availability, but there may be transport barriers to taking children to hospitals. Sometimes we send children out of state, and even just ambulance transport to take them from here to Fargo or Wisconsin, often there are reinforcements because we are competing with very limited resources. “
Bialon hopes to see more investment to expand mental services across the spectrum, from school care to hospitalizations, hospital facilities and long-term treatment options.
“When you deal with this with your child, it’s traumatizing,” she said. “We have to help our health workers, we have to organize ourselves, we are in a crisis but we also have to look at parents and schools and say that there are resources here that we have for you, let’s start here”.
His 14-year-old daughter continues to heal.
Bialon said: “Fourteen has been a good year for her. She is doing really well. ”
If you or someone you know is struggling with their mental health, there are resources available:
If you believe someone is at risk for suicide, the U.S. Department of Health and Human Services suggests:
- Ask questions about whether the individual is having suicidal thoughts.
- Call the United States National Suicide Prevention Lifeline at 988 or 1-800-273-TALK (8255).
- Seek help from a doctor or mental health professional. If it is an emergency, take the person to the hospital.
- Remove all items from a person’s home that could potentially be used in a suicide.
- Do not leave the person alone, if possible, until help is available.
The U.S. National Suicide Prevention Organization has also compiled a list of resources to help cope with the COVID-19 pandemic.