- We have a severe shortage of mental health professionals caring for children.
- ER wait times for children in crisis are growing.
- Funding for child mental health resources should be directed to the community.
I am famous in my town of the Hamptons, not because of my height, and not because of my looks, or a book I wrote, but because I have something everyone needs: I’m a psychiatrist. Often, I get stopped on the street by people who hear about my work and ask me to help. There is such a need for mental health care, which has given me a locally famous presence. I’m a good psychiatrist and I love my job, so I try to help when I can.
The American Academy of Child and Adolescent Psychiatry estimates that the U.S. needs 47 child psychiatrists per 100,000. That’s four times the number found. This is true in the Hamptons, where my neighbors have often made jokes that I should clone myself to be able to meet the needs of our community. I get calls daily from people desperate for help, but I don’t have the bandwidth to take every potential client. I’m so glad to see more people reaching out for help, but one psychiatrist is not enough to meet the need I’m observing.
Though the national conversation surrounding mental health care has grown toward greater acceptance, our healthcare systems have been hard-pressed to make it easier for patients to access the care they need, especially for people of color.
STAT News reported that emergency room visits for children’s mental health concerns are trending dangerously toward longer spans of time and I have found this to be really problematic. I’ve seen patients wait days for a bed, often to get returned to me in the same state of crisis as when I directed them to the ER. They often needed more help than I could provide, and they weren’t able to get that at the next step I was directing them toward.
“Rates of visits that lasted more than six hours for pediatric mental health concerns increased from around 16 percent to almost a full quarter of visits. Stays longer than 12 hours increased from 5 percent to almost 13 percent. Hispanic children are almost three times more likely than white children to experience these delays in care.”1
Though research is still limited as to exactly why these visits are trending longer, it’s imperative that we take a good look at the aspects that we already know may be failing mental health patients.
Emergency room visits are typically the first step toward getting a child into more specialized care to treat their mental health, but all too often, ERs don’t have mental health professionals immediately available. As these visits stretch on for hours upon hours, children may experience more anguish from waiting.
Despite the fact that we encourage children and adolescents to speak up and ask for help, we’re not providing the proper pathways to get them the help they need. How do we create a better pathway for children to get the mental health care they deserve? How do we get healthcare professionals in emergency rooms to treat mental health crises with the same urgency as they would when receiving patients with physical health crises?
The answer lies in funding. We need to take the funding lines out of the insurance business and into the community, as it is the community that directly benefits from having individuals with stronger mental health. Insurance companies generally don’t benefit from having mentally healthier individuals, so why should they be establishing the standards for how mental health care is funded. Every dollar spent on mental health care goes back to society. So why not encourage cities and states to allocate more funds to mental health?
We’ve made a lot of strides toward progress in accepting mental health suffering, but many people still perceive mental pain as less excruciating than physical pain. This feeds down into our subconscious perception of mental health. As long as we consider mental illness as a secondary priority, we’re going to be getting a lot more wrong about mental health than just the emergency room visits.
1: Gaffney, T. (2021, April 5). Kids in the ER are waiting longer for mental health care. STAT News. https://www.statnews.com/2021/04/05/kids-in-the-er-are-waiting-longer-f…
Axelson, D. (2020, April 10). Beyond A Bigger Workforce: Addressing the Shortage of Child and Adolescent Psychiatrists. Pediatrics Nationwide. https://pediatricsnationwide.org/2020/04/10/beyond-a-bigger-workforce-a…
Layard, R. Mental health: the new frontier for labour economics. IZA J Labor Policy 2, 2 (2013). https://doi.org/10.1186/2193-9004-2-2