The number of Medicaid-insured children treated in Connecticut emergency rooms for behavioral health crises rose 20 percent between 2014 and 2016, mirroring a national trend – despite efforts to provide non-ER treatments. In 2014, Connecticut ERs recorded 12,100 Medicaid-insured youth visits compared to 14,448 in 2016, according to a study of Medicaid-eligible patients ages 18 and younger commissioned by the Child Health and Development Institute of Connecticut (CHDI). Most of the children who go to emergency rooms with behavioral health issues go to one of five hospitals, according to data collected by consultant Beacon Health Options, which manages behavioral health care for the state’s Medicaid population. Connecticut Children’s Medical Center in Hartford saw the most behavioral health-related ER visits, with 3,962 visits by Medicaid-insured youth in 2016. Yale New Haven Hospital and Yale New Haven Children’s Hospital had a combined total of 2,263 visits, followed by St.
The state’s efforts to direct children in mental health crisis away from emergency rooms, to other services, have fallen short, with major hospitals reporting staggering increases in patient visits since 2013: Up 32 percent at Connecticut Children’s Medical Center, and 81 percent at Yale New Haven Hospital. The children’s hospital (CCMC) reported nearly 3,300 visits last year – 275 a month, on average — with the average length of stay increasing to 15 hours from less than 12 in 2013. “I wish I could say we had made a lot of progress, but we haven’t,” said Dr. Steve Rogers, medical director of the emergency department’s (ED’s) behavioral health unit. “Unfortunately, I think it’s only going to keep trending this way.”
Similarly, Yale saw ED visits by children ages 15 and younger rise from fewer than 750 in 2013 to more than 1,350 in 2016 — and the numbers are running even higher this year, said Dr. Claudia Moreno, medical director for psychiatric emergencies in Yale’s children’s emergency department. At times, she said, all ED beds are full, and children wait on hallway gurneys.
If you missed our teen depression forum last week you can view it online. Thanks to CT-N, “Uncovering Our Kids: Towards A Better Understanding Of Teen Mental Health” is available for viewing. Learn about the warning signs, various treatments and programs for teen depression from our stellar panel: Dr. Harold Schwartz, psychiatrist-in-chief of Hartford Hospital’s Institute of Living; Kim Nelson, social worker, Wheeler Clinic; Jill Holmes Brown, director, school-based health center; Jeff Vanderploeg, vice president, Child Health & Development Institute; and Nancy von Euler, a mom, who lost her daughter to suicide. The forum is available here.
As state policymakers debate ways to improve mental health services for youths, the Connecticut Health I-Team (www.c-hit.org) is hosting a forum May 7 that will bring together parents, clinicians, educators and others to discuss ways to identify, treat and prevent teen depression. “Uncovering Our Kids: Towards a Better Understanding of Teen Mental Health,” will feature a panel of experts in adolescent behavioral health who will lead a discussion about teen mental health screening, intervention and treatment. The Conn. Health I-Team, in collaboration with ConnectiCare and Hartford Hospital’s Institute of Living, invites the public to come “talk openly about teen mental health, learn from experts, and help Connecticut reduce the stigma of depression and mental illness,” said C-HIT co-founder and editor Lynne DeLucia. The event will run from 5 to 7:30 p.m. at the Lyceum Conference Center in Hartford.
The state needs to enlist pediatricians in screening children for mental health problems, expand school-based counseling services and create regional “care management entities” to help families access treatment, a draft report by the Department of Children and Families proposes. The DCF plan – ordered by state lawmakers in the wake of the Newtown school shootings – concludes that “too many families with children in need of immediate behavioral health services continue to struggle with a fragmented system that is difficult to understand and navigate and lacking in basic capacity across the continuum of services.”
But it stops short of calling for more inpatient and outpatient treatment options, saying more study is needed to identify gaps in care and to see if existing resources can be redeployed. A key recommendation in the plan is that state agencies “pool” existing resources for children’s mental health – an estimated $300 million to $400 million – and re-direct those dollars in new ways. The report does not include data on the usage of existing mental health services or unmet needs. Instead, it calls for that data to be collected, and for a “high level task force” to be convened to lead a multi-year study and redesign of spending on mental health. The plan, which will be refined in the coming weeks based on public input, is the latest in a series of efforts over the last three decades to fix the state’s disjointed system of mental health care for children.