Jena Hausmann, CEO of Children's Hospital Colorado, declared a "State of Emergency" in youth mental health today, a first in the 117-year history of the hospital system. That declaration came during a pediatric mental health media roundtable event that attracted more than 30 journalists from across the state and several national reporters.
"Right now, Colorado's children uniquely need our help," Hausmann said. "It has been devastating to see suicide become the leading cause of death for Colorado’s children. For over a decade, Children’s Colorado has intentionally and thoughtfully been expanding our pediatric mental health prevention services, outpatient services and inpatient services, but it is not enough. Now we are seeing our pediatric emergency departments and our inpatient units overrun with kids attempting suicide and suffering from other forms of major mental health illness."
The reality is that health challenges facing kids have gone beyond crisis levels, and the organizations that serve kids are overwhelmed. Many children, families, local schools, county governments and healthcare facilities are at their breaking points.
Skyrocketing demand for pediatric mental health services
The top complaint being addressed in Children's Colorado's emergency rooms today is kids in a mental health crisis. We've seen a trend of low-level anxiety and depression becoming exacerbated by the isolation and stress of the pandemic then turning into suicide attempts.
"I've been in practice for over 20 years in pediatrics and I've never seen anything like the demand for mental health services we've seen at Children's Colorado in the past 15 months," said David Brumbaugh, MD, Chief Medical Officer for Children’s Colorado. "There have been many weeks in 2021 that the number one reason for presenting to our emergency department is a suicide attempt. Our kids have run out of resilience – their tanks are empty."
Pediatric mental health problems won't simply go away once the pandemic subsides
Jenna Glover, MD, child psychologist and Director of Psychology Training at Children's Colorado, said many children are feeling a sense of hopelessness, which is one predictor of suicidal ideation. She said she is concerned that it won’t simply go away in the next year as the impact of the COVID-19 pandemic subsides.
"Despite things getting better in terms of COVID-19, kids have dealt with chronic stress for the past year that has interrupted their development," Dr. Glover said. "Now kids are asked to be starting back into life again, and they don't have the resources to do that. They're burnt out, and they feel so behind they don't know how to catch up."
How Children's Colorado is working to ensure patients get the care they need
Children's Colorado is making shifts to meet this growing demand. Thanks to generous community donors, we will have increased our mental health inpatient, outpatient and day services by more than 50% by March 2022. We are also expanding facilities to create more space for patients who need mental health services, including an expansion of our Eating Disorder Treatment Program, Intensive Inpatient Unit, Partial Hospitalization Program and Neuropsychiatric Special Care Program, which treats children with severe autism who are in crisis.
"But it's not enough," said Pat Givens, DHA, Chief Nursing Executive, Children's Colorado. "We're still in crisis mode.
"We've had several of our team members working diligently, every day, every hour, looking for placement for these children. The reality is that there are limited resources available in our community and in our state."
Pediatric mental health issues are seen as a tsunami across the state
Children's Colorado has seen a 90% increase in demand for behavioral health treatment in the past two years. Across Colorado, counties are reporting that they are seeing a similar increase in the need for mental health services that they're unable to meet. The new behavioral health unit in the emergency department at Children's Colorado, Colorado Springs servicing Southern Colorado is already over capacity just two years after it was built. Schools, administrators and teachers – all entry points for mental healthcare – say they lack the tools to be effective for all Colorado's children.
We can't depend on building beds to get us out of this," Michael DiStefano, MD, Chief Medical Officer for Children's Colorado's Southern Region. "If we are building acute beds, we are losing the battle against suicide and behavioral health problems with our teens. We need to be intervening prior to the crisis."
Emergency transport teams are now seeing three to four suicide attempts per week and have asked for additional training on how to best handle these situations.
Coming together to help kids cope and keeping them out of the hospital
It's clear that to protect Colorado's children, we can only make progress by working together. "If we don't, we will lose even more children," Hausmann added.
Creating a system that allows all the people and parties to work together will take additional funding. The American Rescue Plan (ARP) Act will provide $3.9 billion to Colorado, and we must ensure that a fair amount is designated for pediatric mental health.
"At a time when we are seeing volumes increase, severity increase and overall need, the system that is meant to be in place to serve these kids does not only not exist, but those who are attempting to do this work are currently underwater," said Heidi Baskfield, Children's Colorado's Vice President for Population Health and Advocacy.
A statewide problem
The mental health crisis in Colorado impacts every part of our state. In fact, many rural communities feel the epidemic even more acutely than urban and suburban communities because resources are more limited in those areas.
"Behavioral healthcare for our tiniest residents has, in fact, become a crisis," said Tamara Pogue, Summit County Commissioner. "I know that unless we make deeper and even more significant investments in this system of care and our safety net, we will continue to lose more children."
Michelle Murphy, Executive Director of the Colorado Rural Schools Alliance, expressed concern about the impact of student mental health on teachers in rural communities. She said, "Educators need training to understand and identify mental health concerns so they can refer students out to appropriate resources in our community. School-based supports are fantastic, but I don’t want to create the idea that teachers should be the front-line mental health providers for our students and staff."