On January 24, an 8-year-old boy from Jamaica Plain was taken to the emergency department at Boston Children’s Hospital. He was in a mental health crisis and had just had an outbreak at home.
Karin Broadhurst became the boy’s foster mother when he was 4 years old. She adopted him a few years later. Broadhurst knew he had been abused and neglected before he was in her care. He has post-traumatic stress disorder and sometimes acts dangerously or aggressively, she says.
That night, he grabbed her medication.
“He was on top of my bed and he picked up my medical organizer, and he threw it as hard as possible on the floor and it burst open,” Broadhurst recalls. “It has a lock, but it’s not very heavy. I think it’s meant for old people, not for children with mental health. So it burst open and my medication flew through the whole room … he started “I grabbed the medication and threatened to swallow it. And I had to physically hold him until the police arrived.”
Broadhurst, a single mother, says because of her son’s trauma history, he goes into ‘fight or flight mode’.
“And he feels out of control,” she said. “I don’t think he was going to kill himself. I think he was just … trying to do something he knew would be really bad and upsetting.”
Broadhurst says she sometimes has no choice but to call 911 to transport her son safely to the hospital.
When they got to Children, doctors wanted to pick up the child. But there were no psychiatric beds available for children in Massachusetts. He spent five nights waiting or “stepping in” in an emergency. He was then moved to a regular medical floor in the hospital. On February 26, he had been aboard Children’s for 33 days.
“If he [had an inpatient psychiatric bed], he would be in a unit with other children similar in age, “his mother said. Those children have therapeutic activities and groups during the day. The psychiatrist who sees him will change his medication if necessary. He would meet with a clinician, and that clinician would do therapeutic work with him and set goals for him.
“He actually just sits in a room all day and plays with Legos and watches TV and plays video games,” she added.
Broadhurst said the daily check-in with her son at a psychiatrist or social worker in the hospital involves asking him a handful of the same questions about whether he or she feels safe or whether he or she is hurting himself or herself or others.
Dr Patricia Ibeziako, co-head of clinical services in the psychiatric ward at Boston Children’s Hospital, said doctors are starting and changing treatments as patients walk in – but the situation is far from ideal.
“What we really want to see is that children can get the right care in the right environment at the right time. And walking in is not a reflection of people who are in the right environment for the right care they need,” he said. said Ibeziako. said. “Residence attack affects children and adolescents with psychiatric illnesses significantly more than those with medical illnesses. And the problem was significantly exacerbated during the pandemic.”
At the end of this week, there were 40 children walking into the children while waiting on psychiatric beds – 16 of them went into the emergency department, and the rest into medical rooms, Ibeziako said.
“It’s ridiculous … And we can’t wait six months or a year until some hospitals build or add rooms. They need to find a solution now.”
Andreas Broadhurst
According to the State’s Executive Office for Health and Human Services (EOHHS), the influx of psychiatric beds among children and adults has increased between 200% and 400% per month since June in the same months last year.
After a patient is on board for 60 hours, the case is taken to the state Department of Mental Health, which must try to locate a bed. For pediatric patients, it takes an average of four days to find one, an EOHHS spokesman said.
Broadhurst’s son has been waiting four weeks longer than that. Earlier this week, they celebrated his ninth birthday in the hospital. She says she wants lawmakers and state officials to prioritize children’s mental health more than they currently do.
“… it’s a crisis, and they can find a way to make extra beds for COVID in an emergency. And they need to be able to find a way to make extra psychic beds for our children in an emergency. crisis, “Broadhurst said.” It’s ridiculous … And we can’t wait six months or a year for some hospitals to build or add rooms. They need to find a solution now. “
The state Department of Mental Health says it is working with providers to launch more psychiatric beds this year. About 200 beds are expected to be created by spring, and the state is offering special incentives for pediatric beds, including the reimbursement rate increases. Boston Children’s Hospital says it is adding twelve psychiatric beds to its Waltham plant this fall. It currently has 16 such beds in its Boston hospital and 12 short-term beds for acute residential treatments in Waltham.
Suppliers say that it is difficult to know what dent the new beds will make because the full extent of the boarding problem is not clear.
“There is no real comprehensive data source there about the full extent of the boarding problem,” said Amara Azubuike, director of behavioral health policy and advocate at the government relations department at Boston Children’s Hospital. “We do not have the full number on how many children walk in, where they get in, what level of care they need and how many beds are in operation at a time.”
Legislation has just been introduced on Beacon Hill to create an online portal that can track in real time how many children are entering which hospitals, what their needs are and how many beds are available in hospitals across the state, Azubuike said.