In a recent report, a CDC-led research team found that less than half of U.S. hospital emergency departments had clear policies in place for treating children with behavioral problems. Getting to the bottom of any complex behavior problem can take days of patient observation, at a minimum, psychiatrists say. And many emergency services don’t have the specialists, dedicated premises, or offsite resources to do the job well.
For Jean, diagnosing his son was complicated. He has since developed irritable bowel syndrome. “He lost weight and started smoking weed due to boredom,” Jean said. “It’s all due to anxiety.”
The Nationwide Children’s Hospital in Columbus, Ohio has a decent-sized emergency department for a pediatric hospital, accommodating 62 children or teens. But long before the arrival of the coronavirus, the department was struggling to manage an increasing number of patients with behavioral problems.
“It was a huge problem before the pandemic,” said Dr. David Axelson, chief of psychiatry and behavioral health at the hospital. “We are seeing an increase in emergency room visits for mental health issues in children, particularly for suicidal thoughts and self-harm. Our emergency department was overwhelmed, having had to take children to the medical unit while waiting for psychiatric beds.
Last March, to deal with overcrowding, Nationwide Children’s opened a new pavilion, a nine-story facility with 54 beds dedicated to observation and longer-term stays for people with mental disorders. This eased the pressure on the hospital’s regular emergency department and greatly improved care, Dr Axelson said.
In this pandemic year, with the number of admissions for mental health issues up about 15% from previous years, it’s hard to imagine what it would have been like without the additional and dedicated Behavioral Clinic, Dr Axelson said.
Other out-of-state hospitals often call, hoping to place a patient in crisis, but there just isn’t enough space. “We have to say no,” Dr Axelson said.