Kids are Still Stuck in ERs for Psych Beds

I apologize for this dated article and reference, but it reminds us all again of a problem linked to the overall policy and planning malfeaseance committed by mental health planners, bureaucrats, policty wonks, legistlators from the state to federal levels, in pursuing the idiotic policy of closure of psychiatric inpatient treatment beds and resources in the publich AND private areans. That error, is of course, one of the triads of haunting reminders of our big “boo-boo” of turning mentally ill out of treatment facilities too early, not having beds for them and not providing even a fraction of the known needed “community based resources,” and that is patients stuck in ERs around the country for days. This article came from the online edition of WXYZ News of Detroit MI, a state that was one of the earlies states to undertake “mental health reforom” under then Gov. John Engler in the decade of the 1990’s. This aticle was published in June, 2015 and showed that nearly 15 years after the start of mental health refrom in Michigan, children  were STILL waiting indeterminate periods of time for a child psychiatric bed to open up for their needed attention. In crisis, mentally ill boys and girls are waiting days for a hospital bed.

Suffice it to say that FIFTEEN years is a long time to have such a serious state-wide problem to persist with little or no solution in sight. I sincerely doubt that if one of the essential transportation arteries running through Detroit were disabled for a period of 15 years, that the city fathers and mothers would do nothing for 15 years, or that if the famous sculpture that embodies Detriot in front of Cobo Arena were somehow stolen or damaged beyond recognition, would it sit unaddressed for 15 years.

The story I wish to borrow from the narrative of this news report that illustrates the person based reality of this grim state of affairs, concerns a boy name Liam who had inordinate and frankly dangerous difficulties getting treatment for his condition and for his safefy. I would like to quote from the article to give the reader a first hand feel for the gravity of this all to common emergency:

“I was home alone with him and his little sister and he attacked me,” she recalled. “It was behavior that was not my child. It was like I had completely lost my child.”

Already diagnosed with autism, that’s when Liam first showed signs that he was bipolar.

“He’s talking about wanting to die every single day, “Mama, I can’t take it anymore,'” Miltimore said. “He begs me to kill him because he can’t take the pain anymore.” At moments like this Kelly knows the only place that can help her son is a hospital, but there are no guarantees there will be bed space is available.

If Liam had a broken leg or needed stitches, he’d have no trouble being admitted. But because he suffers from mental illness, there’s a good chance he’ll be turned away.

“We were told there were no beds,” Kelly recalls. “So we stayed in the ER all day. We restrained him in the ER.”

Day one turned into day two and, still, no beds were available. With Liam getting worse, his mom decided she couldn’t wait any longer and started looking herself. Nearly a week after she tried to admit her son to a Michigan hospital, she found one that would finally take him, 270 miles away in Illinois.

“There is no medical system prepared for these children over,” Milton Moore said. “It’s our check how they’re treated.” What

What happened to Lee Young isn’t unusual. When Kelly Abdallah’s son Jacob attempted suicide, she took him to the acclaimed University of Michigan Hospital in Ann Arbor.

There were only 14 psychiatric beds for children like her son, and they were all full.

It took them 24 hours for them to find a bed for him,” Abdullah said. “There was nothing available for him in Michigan anywhere.”

 

Linda Zeller is a deputy director for the Michigan Department of Health and Human Services. She says that, on paper, the state has enough hospital beds to care for Michigan’s mentally ill children. But in reality, she knows that’s not the case.

 

“There is an unmet need in terms of access to inpatient beds,” Zeller concedes. She blames a complex of circumstances that can lead to a waiting list, like a hospital staffing level, each patient’s intensity of needs and even if a child is a boy or a girl.

We need both short and term and long term solutions to this problem,” Zeller told Channel 7’s Ross Jones.

“What is the short term solution when I go to the hospital today for my son who is suicidal and I’m told we don’t have a bed today, we won’t have a bed tomorrow and there’s not a bed in the state?” Jones asked.

“Short term we have to work with the broader healthcare community, the emergency room, the inpatient health Center, the state she said.

But the state could be doing more to alleviate the problem it runs the Hawthorne Center in Northville, a publicly funded psychiatric Hospital for children. It can house up to 118 patients needing care, but this year it’s funded to serve only 55. Zeller says adding beds could offer some relief, but won’t solve the bigger issue.

Hawthorne beds cannot be the only solution to the problem,” she said.

“I don’t think anybody,, believe me, is saying that they need to be the only solution,” Jones said. “But if your son is cutting himself and you need to do something right now, you’re not interested in the long term fix, you need a short term one right now before something awful happens.”

“Right so we do need a short-term solution,” Zeller said “we absolutely do. And we’re working hard to address those… I don’t have a magic answer for you because this is a very deep, wide, multifaceted challenge.”

But parents like Kelly Miltimore say they’re not asking for a magic answer, just a hospital with room for her son. Since Liam’s last manic episode, his name has been on a waiting list at two different hospitals. He’s still waiting, 19 days later.

Quote it makes you feel like you can’t breeze,” she said.

“There’s nowhere to take your child to get the medical care that they need.”

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Author: Frank

I am a older child, adult, geriatric teaching psychiatrist with over 30 years' practice experience in North Carolina, first at Duke as clnical teaching faculty, then in Western NC as a primary child psychiatry specialist. I have taught and supervised child psychiatrists and psychiatrists in training and many other mental health professionals and taught at two medical schools. I have served in many public and private practice settings. My primary interest is in observing and documenting the ongoing mental health reform efforts in the State of North Carolina and documenting its sucessess and failures at all levels. My favorite pastime among many others is spoofing my friends and kids with my deadpan sense of humor.

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