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Children and teens waiting weeks for critical mental health care

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There is a growing crisis in Massachusetts: children and teenagers waiting weeks for mental health care. Often, those waits are happening in emergency rooms or standard hospital beds.Last fall, 13-year old Carly Birmingham felt depressed and suicidal. Birmingham, who identifies as non-binary, shared those feelings with their mother, Gail McCabe.”Anything that they looked at was sort of scary to them. Sort of telling them that it was a way to hurt themselves,” McCabe said.In the middle of the night, McCabe took Birmingham to Boston Children’s Hospital. They were admitted to the emergency department because there was no mental health treatment bed available. They waited there for seven days and nights.”I was looking for help and I’m just like stuck in this small little room. I can’t sleep and it just felt like I was being punished,” Birmingham said.They are not alone. That wait, called boarding, is on the rise in Massachusetts. It happens when a child is admitted to the emergency department or a hospital room while they wait for a mental health treatment spot to become available. This can take days and, in some cases, weeks.”There really has been long-standing under-investment in this space,” said Amara Azubike, Director of Behavioral Health Policy and Advocacy at Boston Children’s Hospital.She said that underinvestment is due, in part, to stigma.”There’s not the same stigma associated with a child with cancer or a child who has a broken arm or a leg. There’s more acceptance, this child needs help,” Azubike said.Since June 2020, the number of kids waiting for mental health services in Massachusetts emergency departments has increased by 200-400 percent, compared to the same month the previous year. It’s still two to three times higher than it was pre-pandemic.Some of that is due to the permanent closure of three facilities: Providence Hospital in Springfield, Norwood Hospital and Westwood Lodge.Bed space has also been impacted by pandemic-related measures. Facilities taking fewer inpatient psychiatric patients for infection control and keeping patients who test positive for COVID-19 together. Right now, there are 357 inpatient psychiatric beds in the state for teens and children 18 and younger. 17 more have been licensed since the beginning of the year. Azubike said these are positive steps, but more investment is needed.One way to do this is using funds from the federal COVID relief bill.”There are billions of dollars coming into Massachusetts right now. Can we think about children’s behavioral health care when we’re allocating some of those resources? Really calling on state lawmakers and the administration to set aside significant resources so that these EDs, these medical floors can be staffed with the appropriate workforce,” Azubike said.The struggle for solutions continues as teens like Birmingham struggle to get the care they need. After a week in the emergency department, they spent another seven days waiting in a different hospital room. Finally being placed in Children’s in-patient unit for kids in crisis.Birmingham’s time there helped and a drawing they made during that time is a reminder of their goals.”The whole building the bridge part is kind of like working on myself to be able to do things that I want to do. This time it was to be able to get home and have everything go back to normal,” Birmingham said.There’s pending state legislation that could help address some of the crisis. The bills would gather data to understand how many kids are boarding, the level of care they need and the beds available. Mental Health Resources211: Call 211 in Massachusetts to get connected with resourcesCall2Talk: The nationwide hotline for suicide prevention and mental health can be reached at 800-273-8255. You can also text C2T to 741741 if you are in fear of self-harmMAMH:Massachusetts Association for Mental HealthNAMI: The National Alliance for Mental IllnessDee Dee’s Cry: A non-profit organization which links communities of color to appropriate resourcesIvy Watts: Mental health empowerment speakerPeer Support Groups: A list of peer support groups available in MassachusettsFamily Support Groups: A list of family support groups available in MassachusettsMetro Boston Recovery Learning Community: MBRLC offers peer-to-peer services for people in recovery from mental health and/or substance use conditions

There is a growing crisis in Massachusetts: children and teenagers waiting weeks for mental health care. Often, those waits are happening in emergency rooms or standard hospital beds.

Last fall, 13-year old Carly Birmingham felt depressed and suicidal. Birmingham, who identifies as non-binary, shared those feelings with their mother, Gail McCabe.

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“Anything that they looked at was sort of scary to them. Sort of telling them that it was a way to hurt themselves,” McCabe said.

In the middle of the night, McCabe took Birmingham to Boston Children’s Hospital. They were admitted to the emergency department because there was no mental health treatment bed available. They waited there for seven days and nights.

“I was looking for help and I’m just like stuck in this small little room. I can’t sleep and it just felt like I was being punished,” Birmingham said.

They are not alone. That wait, called boarding, is on the rise in Massachusetts. It happens when a child is admitted to the emergency department or a hospital room while they wait for a mental health treatment spot to become available. This can take days and, in some cases, weeks.

“There really has been long-standing under-investment in this space,” said Amara Azubike, Director of Behavioral Health Policy and Advocacy at Boston Children’s Hospital.

She said that underinvestment is due, in part, to stigma.

“There’s not the same stigma associated with a child with cancer or a child who has a broken arm or a leg. There’s more acceptance, this child needs help,” Azubike said.

Since June 2020, the number of kids waiting for mental health services in Massachusetts emergency departments has increased by 200-400 percent, compared to the same month the previous year. It’s still two to three times higher than it was pre-pandemic.

Some of that is due to the permanent closure of three facilities: Providence Hospital in Springfield, Norwood Hospital and Westwood Lodge.

Bed space has also been impacted by pandemic-related measures. Facilities taking fewer inpatient psychiatric patients for infection control and keeping patients who test positive for COVID-19 together.

Right now, there are 357 inpatient psychiatric beds in the state for teens and children 18 and younger. 17 more have been licensed since the beginning of the year. Azubike said these are positive steps, but more investment is needed.

One way to do this is using funds from the federal COVID relief bill.

“There are billions of dollars coming into Massachusetts right now. Can we think about children’s behavioral health care when we’re allocating some of those resources? Really calling on state lawmakers and the administration to set aside significant resources so that these EDs, these medical floors can be staffed with the appropriate workforce,” Azubike said.

The struggle for solutions continues as teens like Birmingham struggle to get the care they need. After a week in the emergency department, they spent another seven days waiting in a different hospital room. Finally being placed in Children’s in-patient unit for kids in crisis.

Birmingham’s time there helped and a drawing they made during that time is a reminder of their goals.

“The whole building the bridge part is kind of like working on myself to be able to do things that I want to do. This time it was to be able to get home and have everything go back to normal,” Birmingham said.

There’s pending state legislation that could help address some of the crisis. The bills would gather data to understand how many kids are boarding, the level of care they need and the beds available.

Mental Health Resources

  • 211: Call 211 in Massachusetts to get connected with resources
  • Call2Talk: The nationwide hotline for suicide prevention and mental health can be reached at 800-273-8255. You can also text C2T to 741741 if you are in fear of self-harm
  • MAMH:Massachusetts Association for Mental Health
  • NAMI: The National Alliance for Mental Illness
  • Dee Dee’s Cry: A non-profit organization which links communities of color to appropriate resources
  • Ivy Watts: Mental health empowerment speaker
  • Peer Support Groups: A list of peer support groups available in Massachusetts
  • Family Support Groups: A list of family support groups available in Massachusetts
  • Metro Boston Recovery Learning Community: MBRLC offers peer-to-peer services for people in recovery from mental health and/or substance use conditions
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