Kids in Crisis: Children left waiting in ERs for care

Published: Jun. 27, 2019 at 2:55 PM EDT
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WCAX is investigating kids in crisis waiting in the emergency room for days, even weeks for mental health treatment.

Hundreds end up in the ER each year around Vermont for psychiatric help and most go home. But when they need a higher level of care, that's when we found the bottleneck begins.

The Vermont Department of Mental Health says last year, 52 kids who were considered a danger to themselves or others had to wait for placement. Their average stint in the ER was about three days.

The department doesn't have the numbers for families whose children sought help on their own.

But the ER is an overwhelming place for a child. And while everyone we spoke with agrees kids shouldn't be waiting in the ER, when we asked how to fix the problem no one had a clear solution.

Our Cat Viglienzoni spoke with a family who says they're frustrated by a system that they say is failing.

The mom who came forward to share her son's story says she did it because she wants to shine a light on a problem that puts her family and child in danger and to let other parents struggling to get mental health care for their children know they're not alone.

"He's a fantastic kid. He is creative and athletic. He's funny," said Katelyn Rea of Colchester.

Rea loves her son. The 11-year-old plays basketball and adores his pet hamster. But she's asked WCAX News not to show his face because he struggles with mental health issues serious enough that police and crisis responders have had to get involved.

Reporter Cat Viglienzoni: Is the system working?

Katelyn Rea: The system is not working at all.

She says they want him to get treatment. He's already been through the Howard Center's Jarrett House and hospitalized at the Brattleboro Retreat. But last month he ended up in the ER again. Rea says he waited there for a bed to open up at the Retreat for 13 days.

"It's an emergency room and it's meant for emergencies. It's not meant for people to sit there waiting for upward of two weeks for some sort of treatment," she said.

And at the end of it all, Rea says the Brattleboro Retreat decided not to take her son, leaving them back at square one.

Cat Viglienzoni: What does it feel like when you get to the ER and you've been waiting for a week, up to two, and then you find out that you just have to take your child home?

Katelyn Rea: It's very frustrating and it's heartbreaking... If you can get something fixed or you can work toward getting something fixed, it's a positive thing. And then to be told that that's not going to happen-- it's really devastating.

Psychiatrists say the longer a child waits to get appropriate care, the worse the mental illness gets.

"It's frustrating for everyone," said Dr. David Rettew, a child psychiatrist and the medical director of the Vermont Department of Mental Health.

Rettew says Vermont has good clinicians and good integration of mental health care between the school system and primary care. But...

"We are absolutely struggling in some areas," he said.

He thinks kids are waiting in the ER for too long. The Brattleboro Retreat is the only in-state inpatient option for Vermont's kids.

Cat dug into the numbers and found there are 30 beds at the Retreat for kids. They're split between age groups. In 2018 there were 12 beds for children 5-12 and 18 beds for kids 12-18.

The Retreat said they had 797 youth admissions last year and many of them were repeat visitors, for a total of 590 individuals.

Asked if they think the state needs more beds for kids in crisis, they said it's hard to say. That's because last year they had 10,950 bed days available for youth. And 9,553 of them were used. So, in theory, there should be four beds available each day. But the Retreat says the reality is the demand for mental health treatment goes up and down, so some days there are no beds available and other days there are several.

Many of the mental health officials WCAX News spoke with, though, say they believe there is a need.

"The bottom line is I think we do need some more acute care beds," Rettew said.

Rettew says stronger outpatient care would likely help shorten wait times, too. That's where the Vermont Mental Health Department is focusing.

"Expanding our inpatient capacity is urgently important, but it's not the only answer," Vt. Mental Health Commissioner Sarah Squirrell said.

Squirrell says adding more beds is not the only fix. Her department is looking at several solutions, including:

-Intervening earlier with children

-Strengthening mental health services in public schools

-Strengthening outpatient programs

-Addressing stigma

But she says they routinely hear from families who are struggling in the system. And she wants parents to know they are listening.

"These stories are heartbreaking from my perspective," Squirrell said.

Katelyn Rea says she wants less talk and more action.

"Things don't move very fast," she said.

Because each day her child isn't in treatment puts him and the rest of her family at risk.

Cat Viglienzoni: What has been the scariest moment for your family so far?

Kately Rea: It's every time that I feel completely helpless. It's when I know what's best for my child and I can't do it.

The mental health department is in the middle of an evaluation process mandated by lawmakers to assess how Vermont's mental health system is working.

Right now, they're doing a listening tour around the state to hear from patients about what is and isn't working and to develop a 10-year vision. They plan to have that done for the next legislative session.