Overwhelming mental health visits are not for us, docs say

The mental health crisis affecting America’s children and teenagers is overwhelming hospital emergency rooms, say doctors.

Parents are bringing in children as young as 5 or 6 years old with psychiatric emergencies like anxiety, depression and suicide attempts — but they’re finding ERs are often unable to help.

“This crisis is only getting worse,” Dr. Willough Jenkins, psychiatrist and medical director at Rady Children’s Hospital in San Diego, California, told NBC News. “It’s not getting better.”

Jenkins noted that the number of kids seeking psychiatric emergency care at her hospital has spiked from about 30 a month in the past to 30 per day in recent months.

Children as young as 6 years old arrive in the ER talking about committing suicide.

In response, three of the nation’s biggest medical care organizations — American Academy of Pediatrics, American College of Emergency Physicians and Emergency Nurses Association — are now pleading for government officials to increase access to mental health services.

Children as young as 6 years old arrive in the ER talking about committing suicide, doctors report.Getty Images/iStockphoto

“That is not who we are as ER physicians. We are not mental health professionals. We cannot provide definitive care,” Dr. Mohsen Saidinejad, director of pediatric emergency medicine at the Ronald Reagan UCLA Medical Center, told HealthDay.

ER visits at children’s hospitals caused by mental health problems jumped 120% between 2007 and 2016, the report from the medical care organizations said. Meanwhile, the rate among general hospitals rose by 55% during the same period.

And these data don’t include the mental health impact of the COVID-19 pandemic.

“The pandemic thrust inadequacies of the US mental health system for children into the spotlight,” Dr. Jennifer Hoffmann, a pediatric emergency medicine physician at Ann & Robert H. Lurie Children’s Hospital in Chicago, told Axios.

Emergency departments are equipped to handle cases like car crash victims, broken limbs, gunshot wounds and other traumas. Most are not able to handle problems that require longer-term treatment and follow-up like mental health crises.

“For every 124,000 children, there is one mental health professional, which is completely inadequate,” said one expert.Getty Images/iStockphoto

But in most cases, the lack of mental health support leaves families with nowhere to turn but their local emergency room.

“The ER has become a de facto referral center for all of these problems, and there’s too many of them for the emergency department to manage,” added Saidinejad, lead author of the report published this week in Pediatrics.

“We can screen, we can identify those at harm risk, but that’s about it, so the ER is really not the most appropriate place to manage these cases,” Saidinejad said. “And I think we are becoming that because there isn’t any other place for these kids to be sent.”

Indeed, the dire lack of mental health professionals nationwide is heightening the crisis for children — as well as adults — who desperately need help.

“For every 124,000 children, there is one mental health professional, which is completely inadequate,” Saidinejad said. “As many as 55% of all of the counties in the United States do not have one psychiatric professional.”

ER doctors lack the training and the ability to follow through on pediatric mental health crises.Getty Images/iStockphoto

The report authors made several recommendations on how to address the pediatric mental health crisis, including: activating mental health crisis teams as an alternative to law enforcement; creating a referral network among hospitals and outpatient treatment centers; developing professional standards for youth mental health consultations; and increased funding to train a diverse population of pediatric mental health providers.

“There must be an availability of options and resources that people are aware of, so they don’t say everybody needs to go to the ER,” Saidinejad said.

“We in the ER are basically a safety net. We can’t say no to anything. We have to accept whatever comes our way. And I think that is why everybody is referring these children to the ER,” Saidinejad added.

If you are struggling with suicidal thoughts or are experiencing a mental health crisis and live in New York City, you can call 888-692-9355 for free and confidential crisis counseling. If you live outside the five boroughs, you can dial the 24/7 National Suicide Prevention hotline at 800-273-8255 or go to SuicidePreventionLifeline.org.

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