May 25, 2021, CT Mirror: Children with psychiatric needs are overwhelming hospital emergency departments in CT https://ctmirror.org/2021/05/25/children-with-psychiatric-needs-are-overwhelming-hospital-emergency-departments-in-ct/
The night before 11-year-old Ella was admitted to Connecticut Children’s Medical Center in early May, her father Sean thought his daughter’s mood seemed “wonderful.” Ella had been diagnosed with depression and anxiety, and their nightly strolls, which helped her relax before bed, were a chance to reflect on the day and talk to her parents about how she was feeling. … But the following day, Ella was caught trying to stick a sharp object into an electrical socket at school. When confronted by a nurse and counselor, the 11-year-old responded, “I just want to die,” her father said. The CT Mirror is withholding Ella and Sean’s last names at the family’s request to protect the child’s privacy. “They called 211 because of the suicidal intentions that she declared, and apparently she told them that she had been feeling increasingly suicidal over the past month,” Sean said. “It was very hard to hear.” Ella was taken by ambulance to Connecticut Children’s Medical Center in Hartford, where she waited with other children in a crowded hallway of the emergency department for about four hours before she could be moved to a room in the unit. She waited there six days, with a psychologist coming in every day to check on her, before a bed opened up at Hartford HealthCare’s Institute of Living. Ella’s experience is emblematic of what is happening around the state. As the pandemic has dragged into its second year, health care providers are reporting a growing crisis in children’s behavioral health care. Increasing numbers of school-aged children are showing up at Connecticut emergency departments — many of them suicidal, out of control, or with hard-to-treat eating disorders — leading to an overflow of young patients in emergency departments with limited bed space and a long wait for inpatient or community-based care elsewhere, hospital officials said…. Dr. Steven Rogers, emergency department physician and medical director of emergency behavioral health services at Connecticut Children’s, said the circumstances in the hospital’s emergency department have been hard for everyone…. Throughout the month of April, more than 30 children with psychiatric needs waited in Connecticut Children’s 48-bed emergency department on any given day. By the end of the month, that number increased to an average of 40 children showing up in the hospital’s emergency department on any given day, the highest day registering at 47, hospital officials said…. This surge isn’t unique to one Connecticut hospital. At Yale New Haven Children’s Hospital’s emergency department, 15% to 20% of its patient volume is related to behavioral health. Hospital officials say that while emergency department visits overall have declined, the number of children who are awaiting inpatient beds for psychiatric care has increased exponentially during the pandemic…. Downs explained that April is usually the time of the year when hospitals see high volumes of kids coming in with behavioral health issues since it’s the end of the school year. But she doesn’t anticipate any relief until schools let out for the summer…. More acute illnesses Both Connecticut Children’s and Yale New Haven are not only caring for more children with behavioral health problems in their emergency departments, but each facility is also seeing a high volume of patients over the last several months with more acute illnesses. “Our most frequent diagnoses in the emergency department would be kids with suicide [risk] or kids with aggressive episodes where they’re in danger of harming others,” Downs said, adding that the intensity of their symptoms are “much greater than is typical.”… Within the past year, the hospital has also seen an increase in the number of children with eating disorders, Downs said…. “The patients who come in wanting to hurt themselves — so not even just having thoughts of hurting themselves but actually you know potentially harming themselves — seems like it’s higher,” said Siew of Yale New Haven Children’s Hospital. “I wouldn’t say completion, but rather really the acuity of their disease, of their mental health disease, is more severe than I’ve ever seen it before.”… ‘We’re just seeing this whole systemic back up.’ Pediatric patients at both Connecticut Children’s and Yale New Haven are waiting in the emergency department for several days — an average of seven days at Connecticut Children’s in April, hospital officials said. Hospital officials explained that most of the wait is due to other facilities and programs that normally handle children with these needs in the communities being overwhelmed. … Child Health and Development Institute of Connecticut President and Chief Executive Officer Jeff Vanderploeg said the crisis happening in emergency departments is not the fault of the hospitals and agreed with providers that it’s “a system issue.”… He said schools could provide social-emotional learning so that kids can recognize and talk about these issues early on. School-based interventions and pediatricians talking about mental health with their patients would also help, Vanderploeg said, and could prevent kids from showing up in emergency departments in large numbers…. In 2018, the University of Connecticut School of Social Work released a report that found that, over an 18-month time period, there was a 25% decrease in emergency department visits among children when mobile crisis was utilized. Last month, 2-1-1 and mobile crisis received 1,363 calls. Of those calls, 1,037 or 76.1% were handled by mobile crisis, according to a monthly report published by CHDI…. Gov. Ned Lamont’s plan for the most recent round of federal funding calls for the money to go toward expanding programs like mobile crisis by making it a 24-hour service along with plans to expand psychiatric services for kids by providing increased pediatric inpatient bed capacity — the state must use nearly $630 million of the American Rescue Plan funds specifically for child care and mental health services, capital projects, and education. Proposed legislation this session like Senate Bill 2, or An Act Concerning Social Equity And The Health, Safety And Education Of Children, is also aimed at expanding mental health services and interventions for kids by implementing mental health screenings and suicide prevention training in local and district health departments. The legislation has passed the state Senate and is waiting to be taken up by the House of Representatives….