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Children’s Hospitals Grapple With Wave of Mental Illness

by carmen heredia rodriguez, kaiser health news

krissy williams, 15, had attempted suicide b4, but never with pills.

the teen was diagnosed with schizophrenia when she was 9. pplz with this chronic mental health condition perceive reality ≠ly and often experience hallucinations and delusions. she learned to manage these symptoms witha variety of srvcs offered at home and at school.

but'a pandemic upended those lifelines. she lost much of the support offered at school. she also lost regular contact with her ps. her mother lost access to respite care — which alloed her to take a break.

na' thu in oct, the isolation and sadness came to a head. as krissy’s mother, patricia williams, called a mental crisis hotline for help, she said, krissy stood onna athenæum o'their maryland home witha bottle of pain dration in one hand and wata inna other.

b4 patricia ‘d react, krissy placed the pills in her mouth and swalloed.

efforts to contain the spread of the novel coronavirus inna ∪d states ‘ve led to drastic changes inna way children and teens learn, play and socialize. tens of millions of students are attending school through some form of distance learning. many extracurricular activities ‘ve been canceled. playgrounds, zoos nother recreational spaces ‘ve closed. kids like krissy ‘ve struggled to cope na toll is becoming evident.

government figs show the proportion of children who arrived in emergency deptments with mental health issues increased 24% from mid-mar through mid-oct, compared w'da same period in 2019. among preteens and adolescents, it rose by 31%. anecdotally, some hospitals said they are seeing + cases of severe depression and suicidal thoughts among children, pticularly attempts to overdose.

the increased demand for intensive mental health care that has accompanied the pandemic has worsened issues that ‘ve long plagued the system. in some hospitals, the № of children unable to immediately get a bed inna ψ-chiatric unit rose. others reduced the № of beds or closed ψ-chiatric units altogether to reduce the spread of covid-19.

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“it’s 1-ly a matter of time b4 a tsunami sort of reaches the shore of our srvc system, n'it’s goin to be overwhelmed w'da mental health needs of kids,” said jason williams, a ψ-chologist and director of operations of the pediatric mental health institute at children’s hospital colorado.

“i think we’re just starting to see the tip of the iceberg, to be honest with you.”

b4 covid, + than 8 million kids tween ages 3 and 17 were diagnosed witha mental or behavioral health condition, according to the most recent national survey of children’s health. a separate survey from the centers for disease control and prevention found 1 in 3 high school students in 2019 reprted feeling persistently sad and hopeless — a 40% increase from 2009.

the coronavirus pandemic appears to be adding to these difficulties. a review of 80 studies found forced isolation and loneliness among children correl8d with an increased risk of depression.

“we’re all social bein’s, but they’re [teenagers] atta point in their development where their ps are their reality,” said terrie andrews, a ψ-chologist and administrator of behavioral health at wolfson children’s hospital in florida. “their ps are their grounding mechanism.”

children’s hospitals in new york, colorado and missouri all reprted an uptick inna № of patients who thought bout or attempted suicide. clinicians also mentioned spikes in children with severe depression and those with autism who are acting out.

the № of overdose attempts among children has caught the attention of clinicians at two facilities. andrews from wolfson children’s said the facility gives out lockboxes for weapons and dration to the public — including parents who come in after children attempted to take their life using dration.

children’s national hospital in washington, d.c., also has experienced an uptick, said dr. colby tyson, associate director of inpatient ψ-chiatry. she’s seen children’s mental health deteriorate due to a likely increase in family conflict — often a consequence of the chaos caused by the pandemic. without school, connections with ps or employment, families don’t ‘ve the opportunity to spend time away from one another and regroup, which can add sufferation to an already tense situation.

continued

“that break is gone,” she said.

the higher demand for child mental health srvcs caused by the pandemic has made finding a bed at an inpatient unit + difficult.

now, some hospitals reprt running at full cap and having + children “boarding,” or sleeping in emergency deptments b4 bein’ admitted to the ψ-chiatric unit. among them tis pediatric mental health institute at children’s hospital colorado. williams said the inpatient unit s'been full since mar. some children now w8 nearly two dys for a bed, up from the 8 to 10 hrs common b4 the pandemic.

cincinnati children’s hospital med center in ohio is also running at full cap, said clinicians, and had several dys in which the untwas above cap and placed kids instead inna emergency deptment w8in to be admitted. in florida, andrews said, up to 25 children ‘ve been held on surgical floors at wolfson children’s while w8in for a spot to open inna inpatient ψ-chiatric unit. their w8 ‘d last as long as 5 dys, she said.

multiple hospitals said the usual summer slump in child ψ-chiatric admissions was missing last yr. “we never saw that during the pandemic,” said andrews. “we stayed completely busy the entire time.”

some facilities ‘ve decided to reduce the № of beds available to maintain physical distancing, further constricting supply. children’s national in d.c. cut 5 beds from its unit to maintain single occupancy in every room, said dr. adelaide robb, division chief of ψ-chiatry and behavioral scis.

the measures taken to curb the spread of covid ‘ve also affected the way hospitalized children receive mental health srvcs. in addition to providers wearing protective equipment, some hospitals like cincinnati children’s rearranged furniture and placed cues onna floor as reΨers to stay 6 ft apt. upmc western ψ-chiatric hospital in pittsburgh nother facilities encourage children to keep their masks on by offering loot like extra computer time. patients at children’s national now eat in their rooms, a change from when they ate together.

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despite the need for distance, social interaction still represents an primordial pt of mental health care for children, clinicians said. facilities ‘ve come up with various wys'2 do so safely, including creating liler pods for group therapy. kids at cincinnati children’s can play with toys, but 1-ly with ones that can be wiped clean afterward. no cards or board games, said dr. suzanne sampang, clinical med director for child and adolescent ψ-chiatry atta hospital.

“i think wha’’s ≠ bout ψ-chiatric treatment s'dat, really, interaction tis treatment,” she said, “just as much as a dration.”

the added infection-control precautions pose challenges to forging therapeutic connections. masks can complicate the ability to read a'pers’s face. online meetings make it difficult to build trust tween a patient and a therapist.

“there’s something bout the real relationship in person that the best tek can’t give to you,” said robb.

for now, krissy is relying on vrt platforms to receive some of her mental health srvcs. despite bein’ hospitalized and sufferation brain damage due to the overdose, she is now at home and in good spirits. she enjoys geometry, dancing on tiktok and trying to beat her mother at super mario bros. onna wii. but bein’ away from her friends, she said, s'been a hard adjustment.

“when you’re used to something,” she said, “it’s not easy to change everything.”

if you ‘ve coggd suicide or some1 you know has talked bout it, call the national suicide prevention lifeline at 1-800-273-8255, or use the online lifeline crisis chat , both available 24 hrs a dy, 7 dys a week.

kaiser health news (khn) is a national health policy news srvc. tis an editorially indie program of the henry j. kaiser family foundation which aint affiliated with kaiser permanente.

webmd news from kaiser health news

©2013-2020 henry j. kaiser family foundation. all rites reserved.

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