Teens need our help coping with COVID

We need more pediatric mental health beds

BEING A TEENAGER has never been easy. These days, the challenge of developing and maintaining a healthy self-image is even more challenging in an era where life is dominated by devices and the constant need to keep up with the latest Instagrams, Snapchats, and TikToks.

And then along comes COVID-19.

Coronavirus has shattered everyone’s normal routines, but especially for those of children and adolescents. Going to school now happens in shifts or via multiple Zoom meetings. Parents, increasingly frazzled by the need to juggle their job and child care, are often working in the same room where their kids are learning. That is, if the parents still have jobs and have not been forced to find alternative ways to pay the bills and keep a roof over everyone’s heads while under- or unemployed.

Playdates? Sports? Team dinners? Plays? Birthday parties? Regular get-togethers with family and friends? That’s so 2019.

According to the National Alliance on Mental Illness, one in five teens and young adults live with a mental health condition. Half develop the condition by age 14 and three-quarters by age 24. The Child Mind Institute’s 2017 Children’s Mental Health Reportnotes that half of the teens diagnosed with major mood disorders don’t adhere to treatment. Studies show 81 percent of teens with anxiety, 71 percent of teens with depression, and 85 percent of teens with ADHD do get better with treatment.

But here’s the rub. Our health care system has historically undervalued behavioral health issues. And the stress on the system has worsened as the pandemic has strained resources of all kinds to the breaking point. If hospitals are going to care for the community, they can’t just care for the profitable pieces of it. I’m proud that Emerson Hospital has maintained inpatient and outpatient mental health services even as other hospitals have cut back in these areas.

But an on-going problem afflicts Massachusetts – the lack of pediatric mental health beds. That means children and adolescents in acute need of psychiatric care are joining adults in being boarded in emergency departments, places that aren’t designed for extended stays. Often they are transferred to inpatient pediatric units, which are ill-suited to provide mental health care.

At Emerson, we see a wide range of mental and behavioral health issues, including depression, dissociation, violence towards others, and self-harm, up to and including suicide attempts. Some of these cases involve children as young as 6. A high percentage of children coming to our Emergency Department in need of acute mental health care are coming outside of our service area.

Successfully treating behavioral health issues is not as easy as sending someone home – especially if they are at risk of hurting themselves or others. As a result, hospitals are forced to keep patients in space that was not designed for or conducive to the patient’s or staff’s health and safety.

And that brings us back to COVID-19.

Public health officials suggest we avoid holiday parties and even consider not gathering with family for the holidays. It’s hard to gauge how much this will affect young people who are already missing important life events like birthdays, confirmations, bar mitzvahs, proms, and graduations.

What we can say with a fair degree of certainty is that the pandemic and its impact will have long-term mental health effects on both children and their parents. And we need to think hard about how we will help families cope with these life stresses.

State and local governments are facing a budget crunch brought on by the pandemic. Without additional federal aid, there are limited options to care for the growing number of mental health patients: either raising taxes or watching as cities and towns are forced to tighten their belts by laying off police, firefighters, and teachers. There is also the possibility that critical state services will be reduced when we need them the most.

Meet the Author

Christine Schuster

President and CEO, Emerson Hospital
As we face sobering times in anticipation of a vaccine or therapies to ease the pandemic, we mustn’t think just about our physical health. We must provide the personal protective mental health equipment to the young women and men already dealing with such a challenging time of life.

Christine Schuster is president & CEO of Emerson Hospital in Concord.