After ‘impact on top of impact’ from the pandemic, Washington has seen a hike in youth needing mental health treatment

On March 26, the governor declared a state of emergency related to youth mental health, as psychiatric units for adolescents were full statewide and wait lists grew longer. Two months later, the demand persists.

“We have more kids in our emergency departments, and I’ve seen our wait lists for our programs are getting longer,” said Katie Morris, behavioral health manager of the Behavioral Emotional Skills Training program at Providence Sacred Heart Medical Center.

Despite the pandemic leading to a drop-off in patients seeking care statewide, the need for adolescent mental health support increased throughout 2020.

At Sacred Heart Medical Center, acute care admissions to its inpatient adolescent psychiatric unit increased 73% in 2020 compared to 2019. In March, it was normal at Seattle Children’s Hospital to admit one or two children each night for attempted suicide, according to the governor’s emergency declaration.

When families bring kids or teens to emergency rooms in a crisis, teams evaluate the level of care they might need.

If a longer hospital stay for psychiatric treatment is warranted, there are 49 beds in the Spokane area at Sacred Heart Medical Center and Inland Northwest Behavioral Health for kids. These inpatient psychiatric hospital beds are for kids 12 to 17 years old at Sacred Heart and 13 to 17 at INBH.

It’s not uncommon for these units to be full, however, and that can lead to kids waiting in emergency departments or other parts of the hospital for days or weeks for a bed to open up.

This is happening not only in Spokane, but statewide.

“Things have not gotten better, and I think it’s a statewide issue,” said Dr. Tona McGuire, the co-leader of the Department of Health’s Behavioral Health Strike Team.

McGuire and the state team are not doing five-year or strategic planning.

“We’re really trying to think of this as an emergency for kids; coming out of a once-in-a-lifetime disaster we’re living through, we need to be efficient and quick,” McGuire said.

The solution is not as simple as adding more beds to hospital wings, however. The state had a shortage in behavioral health providers and programs, particularly for youth, even before the pandemic, McGuire said. A surge of youth needing services, which started earlier this spring, only added pressure to an already patchwork system.

The state is tracking emergency department visits, and some trends persist. The number of kids and teenagers showing up to emergency departments with psychological distress in the last few months was much higher than the same period in 2019.

And while some community members are beginning to come out of the pandemic with hope and a vaccine, youth and young adults are not recovering as fast.

“Anxiety and depression symptoms have decreased slightly over the last couple of months, but not among young people,” McGuire said.

Crises don’t happen in a vacuum, and the pandemic has dealt blow after blow to young people, the majority of whom are accustomed to daily interaction with lots of people at school.

With the isolation from lockdowns and families under newfound stresses of unemployment or threatened health, the last 14 to 15 months have been anything but easy.

“A lot of this surge we’re seeing is impact on top of impact on top of impact,” McGuire said.

Morris, at Sacred Heart, runs a partial-hospitalization program called BEST for kids 8 to 12. Kids get wraparound support services, from therapy to instruction from teachers and family participation. Typically, the program can take about 10 kids at a time, Morris said.

The wait list has gotten longer this spring. Sacred Heart Medical Center also offers a similar partial-hospitalization program for older teens and adults called RISE.

“Everyone is working really hard on trying to support behavioral health and the needs of the community, but if we have wait lists, everybody has wait lists,” she said. “I know that community agencies are working hard to meet the needs, but there are going to be times where you have to wait a few weeks to get into a program, and that’s unfortunately where we are.”

The statewide behavioral health team is working to track data on kids and teens who are waiting in hospitals for a psychiatric bed to open, formalizing each hospital’s wait list so coordination of potential transfers gets easier.

Dan Barth, who leads Spokane County’s behavioral health task force, said referrals go both ways, and Seattle Children’s Hospital had been referring some patients to Spokane as well.

“There are days when there aren’t enough inpatient beds for adolescents,” he told reporters this week.

Experts encourage families to seek treatment for kids and teens who need it, as well as to begin conversations early.

Morris suggests guardians look out for changes in their kids and teens’ behavior and be open to talking and listening to them.

“Ask your kids how they’re feeling; listen to them; give them the space to see how they feel,” she said.

Asking the hard questions, including those about self-harm or suicide, is also important, Morris said.

“Kids want to feel like the important people in their lives are listening to them,” she added.

For mental health resources, visit the state’s webpage. The suicide prevention hotline is (800) 273-8255. The Washington state 24/7 crisis and recovery hotline is (866) 789-1511. The state helpline for teens, called Teen Link, is a call or text line for teens to talk to peers confidentially at (866) 833-6546.

Arielle Dreher can be reached at (509) 459-5467 or at arielled@spokesman.com