Youths with mental health issues fill ERs

US hospital emergency rooms are being severely stretched as doctors attempt to cope with a growing number of children desperately seeking mental health services and who are being left in their care for days or weeks at a time.

On any given night, the children are arriving at hospitals nationwide with their parents in the middle of a crisis. One child, who was not named but was profiled in The New York Times, arrived at Boston Children's Hospital in Massachusetts last year after a suicide attempt.

She was seen by an ER nurse who told her parents she wasn't well enough to be taken home that night. The ER doctor said the child would be better served by a treatment center, not the ER. But there were already 15 other children with mental health issues sleeping in examination rooms.

At least 40 US states and Puerto Rico have seen a dire shortage of child psychiatrists, according to the American Academy of Child and Adolescent Psychiatry.

Data shows that in Massachusetts, the number of children who were taken to the ER seeking psychiatric care increased by 200 and 400 percent amid the pandemic. That trend is being repeated nationwide, say doctors.

It comes as the number of children in the US with a mental disorder grows. In 2019, 13.2 percent of US children aged 3 to 17 — just over 8 million — had a current diagnosed mental or behavioral health condition, according to data from the National Survey of Children's Health.

Suicide attempts among teenage girls rose by 51 percent between 2019 and 2021, according to the Centers for Disease Control and Prevention.

Experts warn that using the ER to treat mental health isn't a viable solution, especially after the stress caused by the COVID-19 pandemic.

"The COVID pandemic has taken such a tremendous toll on the mental health of both our adults and our youth," Dr Lori Pbert, a professor in the Population and Quantitative Health Sciences department at the University of Massachusetts Chan Medical School, told China Daily.

Pbert is part of the US Preventive Services Task Force, a panel of health experts that recommended last year that doctors should screen children as young as 8 years old for anxiety, as that is often a key warning sign for future mental health problems.

In New York City, Children of Bellevue, a nonprofit organization that works to improve the health and well-being of children at local hospitals, also warned on its website that a "lack of accessible and effective mental health care has led to a dramatic increase over the past 20 years in emergency room visits for children and adolescents experiencing a psychiatric crisis".

"Ideally, emergency departments would provide high quality evaluation and treatment planning for young patients in psychiatric crisis," it said. "Instead, families often encounter a system poorly equipped to evaluate and then safely and effectively manage their young child's or teenager's mental health needs."

The organization said that medical emergency rooms or adult psychiatry settings weren't safe or therapeutic places to evaluate children because they "lack access to specialist child and adolescent psychiatric clinicians''.

Throughout the country, the number of residential mental health treatment facilities dedicated to treating children under age 18 went from 848 in 2012 to 592 in 2020, a 30 percent drop, according to the 2020 National Mental Health Services Survey.

A quarter of children who were taken to the ER to get mental health help ended up being readmitted to a hospital or a mental health facility within six months, the American Academy of Pediatrics found in a 2022 study.

After being discharged, many didn't get the vital follow-up visits to check on their mental health quickly enough to stop them being readmitted.

Dr Karen Cassiday, past president of the Anxiety and Depression Association of America, told China Daily: "Although everyone experienced struggles in the pandemic, those who were teens, young adults and parents of younger children appeared to have suffered the most.

"In past history, the norm for any population is to show some impairment in mental health when a mass event occurs, such as famine or war. After six months, most people adapt, and the general population returns to its normal pre-event level of mental health. In the case of the COVID pandemic, this did not occur, especially for the younger population," Cassiday said.

President Joe Biden pledged $300 million to expand mental health services in schools last year. He also said during his recent State of the Union address that schools would be able to use Medicaid dollars to hire additional counselors and social workers.

But only a few schools have one school psychologist for every 500 students, the recommended number suggested by the National Association of School Psychologists. In 2021 to 2022, on average, there was just one counselor to help 1,127 students.