Why parents are taking kids to the ER for mental health needs

Emporia, Virginia – Micale Williams throws the ball easy with his family in their Emporia yard.

The 10-year-old with ADHD has medication today, but about a month ago, he ran out of it.

“He gets really bad vibrations. His body is shaking,” said Michelle Benn, Micale’s mother.

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Ben said Micale was scheduled to see a child psychiatrist at VCU Health Memorial Health Behavioral Health in South Hill. But days before the appointment, the office canceled because the doctor left the clinic.

It just started in March.

“I actually asked, ‘Can they refill their prescription until I figure something out, you know, but no,'” Ben said. “It must be so [the doctor]. “

Ben tried to ask her son’s family doctor to write prescriptions for ADHD medications, but “she said she had to get referral papers from the Care Building before she could refill their prescriptions.”

There aren’t any other child psychiatrists in the area, so Benn felt she had no choice but to take Micali to the emergency room.

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“Nobody likes going to the emergency room, and we had to wait one school night for medication,” she said.

Micale’s story is not unique.

Destiny Walls lives in Midlothian and said she has been trying to get her six-year-old son, Kaelen, with a child psychiatrist since January 2019.

“Everywhere has a six-month waiting list, and by the time the six months are up, they call and cancel and you have another six months to wait,” Walls said. “We ended up going to the emergency room because I wanted to take a look at him.”

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A map from the American Academy of Child and Adolescent Psychiatry shows that there is an acute shortage of child and adolescent psychiatrists in Virginia and elsewhere.

“Part of that is the amount of training and requirements needed to become a psychiatrist, but the other part is what the insurance will bill, the requirements that are in-state for licensing, things like that,” Rachel Reynolds said, with the Virginia Mental Health Program.

The problem has been exacerbated by the increasing need of children for behavioral health services since the beginning of the COVID-19 pandemic.

“We’ve certainly seen an increase in volume in our pediatric and adolescent population here,” said Nelson Smith, vice president of behavioral health at Chippenham and Johnston Willis Hospitals, which is part of HCA Healthcare.

Smith “I imagine it’s scary to hear your child, if they say they want to harm themselves. You don’t know what to do, and the first place you think of is the community hospital you live in and your emergency room,” Smith added.

According to a recent survey by the Virginia Branch of the American Academy of Pediatrics:

  • 90 percent of providers report seeing more behavioral health issues since June 2020
  • 82% saw patients’ first concern as access to child and adolescent psychiatrists
  • 62 percent did not feel able to meet the increased behavioral health needs of their patients

“We know that Virginia ranks 41st in terms of availability of mental health professionals and our mental health workforce, and so we know that there are not enough psychiatrists or even other mental health providers to meet our growing demand,” Reynolds said.

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To try to help, a grant to the Virginia Department of Health allowed the state to set up the Virginia Mental Health Access Program (VMAP).

Pediatricians and other front-line doctors who see children can contact VMAP and consult with a child and adolescent psychiatrist regarding the patient.

“With a 15-20 minute conversation between the PCP and the psychiatrist, they can get the guidance they need to send the family on their way rather than waiting three to six months to see the caregiver,” Reynolds said.

Reynolds said 648 providers are registered to use the system, and psychiatrists receive six to eight calls per day, but awareness of the free program is still needed.

“So, it looks like a lot of providers might not know about the program?” CBS 6 correspondent Melissa Hippolyte asked.

“Exactly, we know we need to do more to get the information out to the primary care community about what’s available to them,” Reynolds said.

Also a long-standing problem is access to inpatient psychiatric beds, something Destiny Walls learned when she took her son to Chippenham Hospital.

“I was like, ‘I’m an inpatient so an option at this point because we’ve been struggling for so long and they said you’re going to be sitting in the emergency room for two to five days before getting a bed,'” said Walls.

“There are children who have been waiting for several days,” said Nelson Smith of Chippenham. “We are one of the few places with beds for children and teenagers. There is a place for us in Petersburg. There is just a huge lack of beds for children and teenagers.”

Why not add more beds?

So, if there is a need, we asked Smith, why not add more beds?

Smith replied, “That’s a good question. There are a lot of places where, I think, yes, I don’t know.”

Felicia Wilson, chief clinical services officer at Chippenham Psychiatric Hospital, Tucker Pavilion, said it would be difficult to find staff for them.

“Recruiting has been very difficult during this time,” Wilson said. “I think a lot of our older employees have retired.”

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This brings us back to Destiny Walls and Michelle Penn.

“It’s tough,” said Walls.

Both said there was more work to be done to help children in crises.

“I feel like they should have more resources for the kids,” Ben said.

In an effort to help with employment issues, this year the General Assembly created a $1.6 million loan forgiveness program for people pursuing behavioral health positions in disadvantaged areas.

Child and adolescent psychiatrists are among the qualified applicants.

VDH said it plans to repay part of about 35 student loans annually.

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