25 Investigates: More MA kids under 12 experiencing mental health crises during COVID-19 pandemic

Lack of pediatric psychiatric beds and services forcing children to “board” in hospital ERs

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Two years of COVID-19 uncertainties and restrictions have harmed the mental health of many Americans. Youths, in particular, have experienced “unprecedented impacts,” according to a recently issued U.S. Surgeon General’s advisory.

25 Investigates wanted to better understand the impact of the pandemic on youngsters. Our team pored over three years of data from the state’s Department of Mental Health and found a soaring number of younger children - kids under 12 – turned to Emergency Rooms across Massachusetts in search of help. The need for psychiatric services spiked early in the pandemic, our analysis revealed.

Investigative reporter and anchor Kerry Kavanaugh found children, even as young as 9-years-old, are in crisis.

“The first few times it was just ‘Why don’t you let me die?,’ Michele Rogers recalls her daughter saying in the early days of the pandemic. Through tears, the Sharon mom told 25 Investigates she was shattered and unsure of how to process her 9-year-old daughter’s words. “You try, but it’s hard,” she said.

To protect the girl’s identity, 25 Investigates will refer to Rogers’ daughter as “Kay.”

Kay, said Rogers, struggled with depression and anxiety before the pandemic. But the isolation and lack of services brought on by COVID-19 made everything much harder.

“Once COVID hit she did start talking about wanting to hurt herself,” said Rogers. " We had a really hard time finding a therapist and not many therapists were doing in-patient therapy. So she was kind of just stuck without anybody other than me. "

In April 2020, at the height of the pandemic, Kay revealed to her mother that she had a plan.

“She told me that it was to run in the street and get hit by cars,” she recounts tearfully.

Rogers said she scrambled to find Kay remote therapy. She did, and ultimately Kay made it through that uncertain period. But things took a turn for the worse soon after the return to school in the fall of 2021. That’s when she had a crisis at an after-school program. Rogers rushed to get her daughter help and took her to Boston Children’s Hospital on October 1st . They ended up waiting for help, or “boarding,” at the hospital for 20 days staying between the hospital’s emergency department and a medical surgical unit.

Boarding is when a patient waits in a hospital emergency department or medical surgical floor until a psychiatric inpatient bed is available.

Kay’s mother says the wait felt longer and more difficult, in part, because for most of their stay “She was pushed off to the side in a room. We saw the nurse very rarely.”

25 Investigates reached out to Boston Children’s Hospital. The hospital didn’t offer comment. But it’s important to note that across the state and country hospitals are seeing an influx of mental and behavioral health patients.

“Emergency departments have really become the last refuge for those patients,” said Leigh Simons Youmans, senior director of healthcare policy at the Massachusetts Health and Hospital Association (MHA), noting that the trend is especially true for children and adolescents.

Our team examined the three most recent years of data from the Massachusetts Department of Mental Health (DMH), focusing on the pediatric cases, or patients between 0 to 17 years of age. From 2019 to 2021, we found a significant rise in pediatric patients in crisis who sought help at hospital ERs during the pandemic.

In May 2020, for example, 86 pediatric patients received in-patient mental health services. Of those, 38 were children under the age of 12. That number represents an increase of 126% from 2019 and a 530% increase from the prior month for patients in that age group.

A trend that is also noteworthy in the data is that each September there was a significant uptick in the number of children seeking mental health services.

The DMH data we reviewed, however, only reflects the number of children who went to an ER and received services, such as a pediatric bed. It does not capture the children who are “boarding” in ERs waiting for a service. The MHA only recently started tracking that number.

Since October, the MHA has collected the number of patients “boarding” in Massachusetts hospitals on a weekly basis.

There were 158 pediatric (ages 0-17) “boarders” the week of January 31st alone.

“The largest barrier to admission was bed availability,” said Simon Yeomans of the MHA. “Those issues are long standing and, you know, this is a moment in which we hope they can finally be addressed.”

Kay’s mother echoes that sentiment. She hopes to see more resources dedicated to helping younger children in crisis, like her daughter.

“One of the problems with her not being able to find a bed was because she was under the age of 10. We need to have more beds. We need to have more facilities for children,” said the Sharon mother.

25 Investigates asked the office of Governor Baker how the administration plans to address the pediatric mental health crisis. They said they are making expansion of mental health resources a priority in the administration’s final year in office. In 2021, the state added 93 psychiatric beds for children and adolescents. Another 80 beds are expected to be added in 2022.

The administration also earmarked $400 million in American Rescue Plan Act {ARPA} funds to expand mental and behavioral health services, including behavioral health workforce needs. Ten million dollars of that will go toward expanding psychiatric urgent care within communities, some which will be dedicated to pediatric needs. Additionally, the fiscal Year 2023 budget proposal contains $115 million in new behavioral health supports, touted the administration. Read more about those here.

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