The impact of the COVID-19 pandemic on our nation has been well documented, but a less publicized mental health epidemic emphasizes the capacity of our hospital systems, particularly children’s hospitals. Now, as the country begins to open up a backup, policymakers and health leaders must prioritize actions to address the startling crisis of children’s mental health.
Pandemic-related school closures left a significant impact on children who were unable to socialize, participate in extracurricular activities, or even family events. These shutdowns also left children without access to school health resources and services, often the first stop for children experiencing unusual stress. As a result, visits to the pediatric emergency department for severe mental health conditions are on the rise.
Between April and October last year, the Centers for Disease Control and Prevention reported that U.S. hospitals increased the proportion of visits to child mental health emergency departments by 24%. from 5 to 11 years. Mental health emergency visits for teens ages 12-17 grew. 31 percent. This spectacular rise now overloads hospitals.
Last month, Dr. Tami Benton, chief psychiatrist at Philadelphia Children’s Hospital, told the U.S. Senate about the toll that the mental health epidemic is affecting children, families and their providers.
“Many of the children we are seeing were managing well in their communities before the pandemic, receiving care from their local mental health agencies, schools and primary care offices, but are now presenting for emergency care due to of a worsening of symptoms, ”Benton said. As a result, Philadelphia Children’s Hospital, where 95 percent of behavioral health care is provided in outpatient centers, now has up to 50 patients a day on the waiting list for mental health beds.
Benton’s testimony is consistent with the experiences of children’s hospitals across the country, where capacity constraints are so severe that children and young people are sometimes forced to wait, in hospital emergencies and in other beds unsuitable for the special care they need, until beds are opened in hospital psychiatric units, often in other states.
Most troubling is that children’s hospitals are often the last resort for families seeking mental health care for their children. If they can’t access it, there may be literally no other place to go. It is worth noting that the pandemic has coincided with a dramatic increase in juvenile suicide rates. Last year, the Cook Child Health System in Fort Worth, Texas, reported a record number of suicide deaths marking the first time that suicide was the leading cause of trauma deaths in the hospital.
While the pandemic has certainly exacerbated the mental health crisis of young people, this problem was going in the wrong direction years before the pandemic. Juvenile suicide rates have risen for a decade, and suicide has become the second leading cause of death for young people and young adults in 2018. It wasn’t until 2013 that we fully understood that mental health conditions begin in childhood.
In addition, it is worrying that symptoms of mental health problems begin to appear at increasingly younger ages. Since 2016, the number of children aged 6 to 12 who visited hospitals for suicidal thoughts or self-harm has more than doubled. The Association of Children’s Hospitals documented 5,485 emergency or hospitalization visits for suicidal thoughts or self-harm to nearly 50 children’s hospitals in 2019, up from 2,555 in 2016.
May is Mental Health Awareness Month, but that number requires more than awareness. Requires action. Children’s hospitals should be the last line of defense in the fight against the mental care crisis facing our young people. Like physical illness, hospitalization is the least desirable and most expensive option, and in mental health it often comes too late to address the underlying causes of the illness.
A good start would be to invest more resources in preventive care. Policy makers need to provide more funding for programs that help educate and train more licensed mental health professionals, doctors and non-doctors. In addition, there needs to be greater support for state and local programs that emphasize mental and behavioral care, school services, and outpatient programs. Finally, we need to help pediatric hospitals expand capacity now to help children in severe crisis access critical services and services. It is estimated that the United States needs approximately 12,600 child and adolescent psychiatrists to meet current demands. We currently have only 8,300.
As our country strives to return to “normalcy,” we must remember that the impact of the pandemic on children will be felt over the next few years. Out of necessity, hospitals became the front lines in the battle against coronavirus. We cannot afford to carry the burden of our struggle for the mental health of children now. These children deserve our full support.