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The Kids Aren’t OK: The Rising Mental Health Crisis in Children
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If you or someone you know are experiencing a mental health crisis, call or text  988, the 988 Suicide & Crisis Lifeline. You can also chat with them at También está disponible en español.

The youth mental health crisis in the United States has reached a tipping point, with emergency rooms struggling to cope. Limited mental health resources outside of hospitals have led to a surge in young clients seeking emergency psychiatric care.

Emergency rooms were not originally designed to provide mental health care, yet they have become an unintended front line in addressing the youth mental health crisis. The lack of mental health support for children outside of hospitals has resulted in understaffed emergency departments being inundated with young clients experiencing behavioral emergencies.

Why the Rise in Mental Health Problems in Children?

The reasons are not dissimilar to adults: much of it was present and exacerbated by social isolation and the many changes of the pandemic. Children rely on adults to survive, so any changes in a parent’s stress levels, job losses, or health problems also affect them. That’s in addition to the normal growing pains and emotional or physical abuse they may face.

Puberty is also happening earlier in children than before, which some studies have linked to emotional and social behaviors growing more quickly than children’s ability to process and regulate such behavior.

Children are growing up in a world more connected than ever – with all the good and bad that entails. In addition to cyber-bullying to unrealistic expectations of body image, wealth, or well-being, children and teens are becoming more aware of factors like war, violence, political polarization, climate change, natural disasters, and mass shootings. All that, without the power and agency adults possess to combat such things.

That’s to say nothing of factors such as poverty, inequality, racism, homelessness, food insecurity, gender orientation, and other social determinants of health.

Inadequate Resources and Challenges

Emergency rooms vary widely in their ability to care for pediatric clients and screen for self-harm risk or substance use. The limited capacity and staff training in managing mental health cases within emergency departments contribute to lengthy wait times and a potential lack of necessary care. This situation is exacerbated by insufficient psychiatric treatment options, resulting in young clients waiting in emergency rooms for a psychiatric bed to become available.

We’ve discussed the shortages in mental and behavioral health providers before, and child psychiatrists are no exception. The number of retirees and graduates remains the same. It’s estimated by the American Academy of Child and Adolescent Psychiatrists that there are about 8,300 practicing child and adolescent psychiatrists in the US. We’d need at least 30,000.

Both schools and mental health care are critically underfunded and low in resources. Add in challenges in integrating mental health care into schools and primary care, the usual barriers to access like costs and social determinants of health, and the lack of knowledge about mental health problems faced by children, and you’ve got a crisis on your hands.

Recommendations for Addressing the Crisis

The mental health crisis among children and adolescents is a complex issue, and there is no one-size-fits-all solution. However, there are several evidence-based interventions that can be implemented to address this problem.  High-profile medical associations, including the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association, have offered recommendations to prevent the need for emergency psychiatric care and improve treatment protocols:

  1. Activate Mental Health Crisis Teams: Establish and use local mental health crisis teams as an alternative to law enforcement intervention, ensuring that trained professionals respond to mental health emergencies and provide appropriate care.

  2. Create Referral Networks: Foster collaboration among hospitals and outpatient treatment centers to streamline the referral process, ensuring that young clients have access to the appropriate level of care beyond the emergency department.

  3. National Professional Standards: Develop national professional standards for youth mental health consultations, providing guidelines and best practices for healthcare providers to follow when treating young clients with mental health concerns.

  4. Increased Funding and Training: Advocate for increased funding to train a diverse population of pediatric mental health providers. Support initiatives to address the shortage of mental health professionals in many areas of the country, ensuring that adequate care is available to all young individuals in need.

Building a Robust Mental Health System

The COVID-19 pandemic has highlighted the inadequacies of the U.S. mental health system, including for children. Pediatric emergency medicine experts emphasize the need to seize this momentum and build a robust mental health system that offers a full continuum of services. By prioritizing prevention and early intervention, we can work towards preventing crises and providing comprehensive mental health support for young individuals.

By intervening early, we can address the underlying causes of the child’s mental health issues and equip them with effective coping mechanisms. This can significantly reduce the likelihood of future mental health problems and ensure better long-term mental well-being. Research has shown that early intervention can lead to improved mental health outcomes, increased resilience, better school performance, and enhanced overall functioning in both childhood and adulthood.

Ignoring or neglecting this crisis can have devastating consequences for their present and future lives. Children with untreated mental health issues are more likely to struggle academically, experience difficulties in building and maintaining relationships, and engage in risky behaviors. Moreover, untreated mental health problems can lead to a higher risk of substance abuse, self-harm, and even suicide. By addressing children’s mental health crisis early on, we can provide them with the necessary support and resources to thrive and reach their full potential. It is imperative that parents, caregivers, educators, and policy makers prioritize the importance of mental health, ensuring that children receive the care and attention they need to lead healthy and fulfilling lives.

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