No Vacancy: How a Shortage of Mental Health Beds Keeps Kids Trapped Inside ERs
The COVID-19 pandemic has led to increasing anxiety and depression among many children and adolescents, and many emergency rooms (ERs) are overwhelmed as a result. The Centers for Disease Control recently reported that ER visits following suicide attempts for teenage girls increased 51% earlier this year compared with 2019. In Massachusetts, so-called "ER boarding" — when psychiatric patients end up in limbo, waiting in hallways or other areas for inpatient beds — has increased 200% – 400% monthly during the pandemic. COVID precautions have cut back on the number of beds in hospitals, and some psychiatric units have been turned into COVID units.
One Massachusetts teenager, who EMTs took to the ER in March after she threatened to kill herself, ended up staying in a hospital lecture hall for 10 days. The teen and a dozen other children slept on gurneys, separated by curtains, because neither the ER nor the hospital psychiatric unit had space. When the overwhelmed and agitated girl tried to escape, she was restrained, medicated, and moved to a windowless room, with cameras to monitor her movements. She was there for another week before a psychiatric bed at a nearby hospital was found. This was the girl's fourth trip to the ER since November. Hospital officials say that when discussing inpatient psychiatric treatment for each patient, they must factor in any unique medical or insurance constraints. Many insurers' requirements for prior approval before agreeing to cover a placement can add delays as well. Massachusetts officials recently introduced a new behavioral health reform plan that aims to keep children out of ERs and provide more preventive and community-based services. While parents and providers are optimistic, they also wonder whether there will be sufficient mental health professionals to staff the planned community clinics, therapy programs, and additional psychiatric hospital beds.
Read more on Kaiser Health News.