In a recent report, a research team led by the C.D.C. found that less than half of emergency rooms in US hospitals had clear guidelines for dealing with children with behavioral problems. Getting to the bottom of a complex behavior problem can take at least days before patients are observed, say psychiatrists. And many emergency rooms don't have specialists, dedicated space, or outside resources to do the job well.
For Jean, her son's diagnosis was complicated. He has since developed irritable bowel syndrome. "He lost weight and started smoking pot because of the boredom," said Jean. "It's all due to fear."
The Columbus, Ohio National Children's Hospital has an emergency room the size of a children's hospital with a capacity for 62 children or adolescents. But long before the coronavirus arrived, the department was trying to treat more and more patients with behavioral problems.
"This was a big problem before the pandemic," said Dr. David Axelson, chief of psychiatry and behavioral health at the hospital. “We saw an increase in visits to the emergency room for mental health problems in children, particularly thoughts of suicide and self-harm. Our emergency room was overwhelmed by this, and children had to get into the medical department while they waited for psychiatric beds. "
In March last year, Nationwide Children’s opened a new pavilion, a nine-story facility with 54 dedicated observation and extended stay beds for people with intellectual disabilities. This has taken the strain off the hospital's regular emergency department and significantly improved care, said Dr. Axelson.
In this pandemic year, when the number of patients with mental health problems has increased by around 15 percent compared to previous years, it's hard to imagine what it would have been like without the additional, dedicated behavioral clinic, said Dr. Axelson.
Other hospitals out of state often call in hopes of getting a patient into crisis, but there just isn't enough room. "We have to say no," said Dr. Axelson.