Children and teenagers with mental health concerns continue to overwhelm emergency departments across the United States. Three influential groups of pediatricians and emergency medicine providers warned this month that emergency rooms cannot sustain the surge in kids seeking emergency psychiatric care without more local resources for youth mental health.
“The scope of this problem is really great,” Mohsen Saidinejad, a professor of emergency medicine and pediatrics at the University of California, Los Angeles told NBC News. “But our ability to solve it is not there.”
Saidinejad is the lead author of a joint policy statement from the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association released on Aug 16. It warns that emergency departments aren’t guaranteed to have the capacity or staff training to manage mental and behavioral health (MBH) emergencies, meaning patients could face lengthy wait times and not get the necessary care.
“An increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure; challenges with timely access to a mental health professional; the nature of a busy ED environment; and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affect patient care and ED operations.”
It’s a scenario Steven Berkowitz, professor of psychiatry at the University of Colorado, is well familiar with. “These children languish, sometimes for days or even a week, in hospital emergency departments,” he recently wrote in an article for The Conversation. “This is not a good place for a young person coping with grave mental health issues and perhaps considering suicide. Waiting at home is not a good option either – the family is often unable or unwilling to deal with a child who is distraught or violent.”
Professor Berkowitz founded CU’s Stress, Trauma, Adversity Research, and Treatment (START) Center. His practice has been focused on youth stress and trauma for three decades. Over those years, Berkowitz noticed that these young patients have become more aggressive and suicidal. “They are sicker when compared to years past. And the data backs up my observation: From 2007 through 2021, suicide rates among young people ages 10 to 24 increased by 62 percent. From 2014 to 2021, homicide rates rose by 60 percent. The situation is so grim that in October 2021, health care professionals declared a national emergency in child mental health.”
The numbers behind the suffering are troubling. For every 100,000 children in the US—with one in five of those children having a mental, emotional, or behavioral disorder in a given year – there are only 14 child and adolescent psychiatrists available to treat them, according to the American Academy of Child and Adolescent Psychiatry.
“At least three times as many are needed,” Berkowitz explained. “There is also a significant shortage of child therapists—social workers, psychologists, licensed professional counselors—as well. This is particularly the case in rural areas across the country.”
“Studies show that young people in the US are increasingly stressed and traumatized. The constant barrage of information via social media and the demand to participate in it is complex, and interactions can be harmful to a child’s mental health. Young people deal with cyberbullying and endless exposure to social media content focused on body image.”
Undiagnosed and untreated mental health issues such as trauma, anxiety, and depression frequently lead to drug and alcohol misuse in a maladaptive attempt to cope with the emotional pain. Professor Berkowitz recommends earlier interventions for struggling children and teens. “When a young person needs treatment, parents should prioritize finding a mental health provider right away. Asking the child’s primary doctor and school counselors for a reference is a good start.”
There is a new treatment option for teenagers at risk in the Denver area. Avanti Behavioral Health recently launched an intensive outpatient program (IOP) for clients between the ages of 13 and 18 in Greenwood Village, Colorado. Our mission is to provide comprehensive, holistic, family-centered, and trauma-informed care for teens.
We believe that recovery from a substance use disorder is a process that should involve the entire immediate family. We have developed an effective and highly involved method of family counseling. For more information about our IOP and family programming call us at (720) 753-4030.