Commentaries are feeling pieces contributed by viewers and newsmakers. VTDigger strives to publish a selection of sights from a broad selection of Vermonters. Commentaries give voice to local community customers and do not depict VTDigger’s views. To submit a commentary, stick to the recommendations in this article.
This commentary is by Ethan Parke of Montpelier, a previous member of the Vermont Well being Policy Council, a co-founder of Vermont Consumers’ Campaign for Well being, and a present-day board member of Vermont Wellness Treatment for All.
The Senate Governing administration Functions Committee has taken up S.39, which would “make customers of the Normal Assembly suitable for the Condition employees’ overall health profit approach at no cost….”
This comes at a time when a lot of citizen advocates have been pleading with legislators to critically take into consideration extending publicly financed most important care to all Vermont people. A Household bill, H.156, and a Senate bill, S.74, would do just that, but each bills absence support from committee chairs and/or legislative management, and hence are unlikely to be reviewed.
Possibly the irony of this scenario is lost on legislators. An alarming percentage of Vermonters are now categorised as underinsured, which means that a serious health issues or injuries would toss them into personal personal bankruptcy. Medicaid eligibility is slated to be tightened this spring as a end result, the number of uninsured Vermonters will undoubtedly quickly rise.
Major care clinicians are leaving the career, dismayed to deal with people who hold off or self-ration treatment, and discouraged by ever-rising administrative complexity and inadequate reimbursement.
Obtaining backed insurance policies on Vermont Health and fitness Link is not a viable solution for several people today, which include probably for some legislators. Otherwise, S.39 would not have been introduced. For working Vermonters who do not qualify for Medicaid, the Wellbeing Join rates are normally unaffordable, and the large deductibles imply that these programs do not deal with primary care, or even issues like a damaged arm, an asthma assault, or a perform-up for chest soreness.
The sponsors of S.39 are keen to deal with this challenge for them selves, beginning up coming January. Regretably, the relaxation of us will proceed to wait.
It’s not that legislators shouldn’t have entry to cost-effective health and fitness treatment. Of program they need to, but all Vermonters are equally deserving. In truth, in 2011 the Legislature passed into legislation a theory that wellness treatment need to be universal and publicly funded. Isn’t it self-serving then for lawmakers to now put their own well being treatment wants forward of individuals of their constituents?
The Joint Fiscal Place of work was requested to estimate the price to taxpayers if legislators were being presented the state employees’ health insurance coverage. These strategies value $12,500 a yr for a solitary man or woman, $25,000 a calendar year for two people, and $34,000 a calendar year for a spouse and children. S.39 states that the insurance coverage would be presented “at no cost” to legislators, but the Joint Fiscal Business office based mostly its estimate on an 80/20 expense break up in between the state and the legislator, as is usual for point out staff members.
If 50 per cent of legislators signed up and paid out 20 percent of the premiums, the JFO analyst explained the tax revenue demanded for the state share would be amongst $900,000 and $2.5 million a calendar year, depending on the combine of person and relatives strategies.
How else could possibly such funds be spent? $2 million could shell out for 10,000 dental cleanings and program oral examinations for Vermonters who deficiency access to dental care, and dental treatment is commonly cited as the most pressing need between equally insured and uninsured Vermonters. Alternatively, $2 million could pay back for 10,000 key care visits to keep track of and take care of substantial blood pressure, diabetes, and other popular problems.
Write-up 7 of the Vermont Structure states that “government is, or should to be, instituted for the common reward, protection, and safety of the persons, nation, or local community, and not for the distinct emolument or benefit of any single particular person, family, or established of individuals who are a portion only of that group.”
S.39 contradicts the spirit of Write-up 7 and presents gain and security to a distinct class, when disregarding the identical requirements of the common folk.
The option is not to deny the advantages, protection and safety of condition law to legislators, but to publicly fund wellbeing treatment for all 645,000 Vermonters. H.156 and S.74 would established us on a path to attain that, when S.39, the bill in the Senate Government Operations Committee, would protect only 180 individuals who inhabit the Statehouse for four and a 50 {bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} months a year.
Ask leaders of health care organizations about their top three challenges for the year ahead, and many answer, “Workforce, workforce, and workforce.” These leaders go on to say that they are struggling to recruit and retain caregivers of all types, that the costs are breaking their budgets, and that morale is at historic lows. As a direct result, every type of performance is suffering: financial, safety, and overall quality, including the patient experience.
With an air of desperation, organizations are trying many tactics, including awarding bonuses for signing, staying, and referring new recruits. They are implementing programs to reduce burnout like mindfulness training and investing in AI and other technologies that reduce administrative burden. All of these tactics to improve compensation and mitigate the deadening aspects of work have merit, but organizations should not rely upon them to create the loyalty and resilience needed for excellence in health care.
Our data on hundreds of thousands of physicians, nurses, and other caregivers in the United States shows that pride in their work and loyalty to their colleagues are the strongest correlates of their readiness to stay with their organization and continue showing up for work. Competitive pay and other support options are essential to recruiting caregivers, of course, but organizational culture, including a commitment to excellence, is what makes them stay.
Improving organizational culture is a leadership challenge that is more complex than finding the money to increase compensation or correcting the problems that cause unhappiness. After all, in life in general, happiness is something beyond the absence of unhappiness. The same is true in health care. For example, “service recovery” programs that quickly address patients’ complaints can mitigate their ire, but lack of ire does not equate to loyalty. Similarly, organizational responses to caregivers’ pain may prove that the leaders care, but it doesn’t mean that the caregivers will keep showing up and doing whatever it takes to meet their patients’ needs.
What does drive loyalty and resilience among caregivers? As is true in other industries during these difficult times, getting back to basics is crucial — and in health care that means focusing organizational culture on the noble cause of reducing patients’ suffering and then supporting caregivers in that work. Our data demonstrates that this is not wishful thinking; it is an operational imperative.
For example, we have analyzed the drivers of loyalty for 410,000 health care employees during the pandemic. In these analyses, we examine factors that correlate with employees’ expressing strong agreement with these two statements: “I would stay with this organization if offered a similar position elsewhere” and “I would like to be working at this organization three years from now.” For both metrics, there has been a marked decline across the country from 2020 to 2022 (on a 1-5 scale, from 4.15 to 4.00 for the first statement and from 3.93 to 3.78 for the latter).
But the patterns of change have not been the same in every organization and for every job type. There has been a “spreading of the pack,” with greater variation than in the past in measures of workforce engagement between organizations doing well and those doing poorly. The data suggests that leadership matters as never before — not just at the C-suite level but also at the front lines where managers really determine how organizational culture feels for employees. For example, there can be vast differences in how caregiver morale in two patient care units that are physically adjacent to each other but have different nurse managers.
Whatever variation exists among managers, there seems to be remarkable consistency in what matters to the people working for them. In our analyses, for all types of health care personnel, their organizations’ commitment to quality and patient-centered care was among the top drivers of their likelihood to stay. When employees gave their organization low ratings on these issues, they were more than six times as likely to say they were preparing to leave. These issues were important to security guards, maintenance, and clerical personnel as well as clinicians.
That finding may seem surprising at first glance, but as one hospital executive said to us, “It makes perfect sense. When patients feel mistreated, they don’t yell at the doctor very often; they take it out on the clerks and security guards. But when patients have a great experience, the clerks and security guards get to bask in the glow – and that makes them want to stay.”
For physicians, the top factors that correlated with their expressed likelihood of staying were whether they like their work, feel the organization is making good use of their skills, and the organizational culture. For example, if physicians felt that the organization did not have an inclusive culture, that increased their risk for considering leaving 5.5-fold. Competitive compensation packages are presumably critical to recruiting physicians, but culture is essential to retaining them.
Press Ganey’s data is completely consistent with the findings of a study of 20,627 physicians and advanced practice clinicians in 120 large U.S. health care organizations by Mark Linzer and his colleagues that was published last November in the JAMA Health Forum. It found that intent to leave had increased from 24{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} in 2019 to more than 40{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} in 2021 but identified several factors that mitigated the risk of burnout. In multivariate regression analyses, positive factors included feeling valued, good teamwork, and having values that are aligned with those of leaders.
Our data for physicians, nurses, and all types of personnel demonstrate a halo of positive effects that accompany these sources of caregiver pride. For example, these measures of overall “engagement” with the organization also correlate strongly with measures of safety culture, such as their confidence in the organization’s commitment to preventing and reporting adverse events — and those safety culture measures are associated with lower rates of safety events. In short, data confirms that excellence in all performance areas that drive business success are intertwined: patient experience, quality and safety, and the engagement of the workforce.
The implications of these findings for health care leaders are that they, of course, must listen carefully to grasp what issues are causing employees’ pain and fear and try to address them. But leaders must also listen to understand their employees’ hopes for what their work means to them and reinforce the aspirations that brought their employees to health care to begin with.
To do that, leaders must be clear about their values, their commitment to safety, the reduction of suffering, and a culture of respect and inclusion. They must prove their authenticity by committing to measuring how things are going on these issues, being transparent with the findings, and using them to improve. The result will be greater workforce loyalty and resilience, which will translate to better performance of all types.
Much is known about the heart-health benefits of adopting a Mediterranean-style diet, with its heavy focus on whole grains, fruits, vegetables, fish and healthy oils. But what about the rest of the Mediterranean lifestyle?
Short of lounging on the beaches of southern Italy or an island in Greece, could adopting the focus on relaxed, familial dining, afternoon naps and strong communal bonds also improve health?
A group of researchers explored what would happen if middle-aged and older British adults—who live about 1,500 miles northwest of the Mediterranean Sea and its convivial way of life—adopted not just the dietary but also the physical activity and social habits of their southern neighbors. And they found that the more they adhered to this lifestyle, the lower their risk of dying from cancer, cardiovascular disease and other health conditions.
The findings, presented Feb. 28 at the American Heart Association’s Epidemiology, Prevention, Lifestyle and Cardiometabolic Health conference in Boston, are considered preliminary until full results are published in a peer-reviewed journal.
“This study suggests that adopting a Mediterranean lifestyle adapted to the local characteristics of non-Mediterranean populations is possible and can be part of a healthy lifestyle,” said the study’s senior researcher, Mercedes Sotos-Prieto, an assistant professor in the department of preventive medicine and public health at the Autonomous University of Madrid, Spain. She also is an adjunct professor at the Harvard T.H. Chan School of Public Health in Boston.
Prior research has shown the Mediterranean-style eating pattern helps protect against cardiovascular disease, lowering the risk for heart attacks and strokes. In this latest study, researchers analyzed the impact of other Mediterranean lifestyle factors—including physical activity, rest, social habits and conviviality—on 110,799 middle-aged and older adults living in England, Scotland and Wales.
Participants were drawn from the UK Biobank, a multi-center, population-based study of people ages 40 to 75 who were free of cancer and cardiovascular disease when they enrolled between 2009 and 2012. They were followed until 2021.
A 25-point MEDLIFE index was used to score their adherence to the Mediterranean lifestyle. The index was broken down into three blocks: Mediterranean food consumption (12 points), which looked at what people ate; Mediterranean dietary habits (7 points), which looked at additional factors such as whether they snacked, added salt to their meals or preferred whole grains to refined grains; and other lifestyle factors (6 points).
The last block included questions on whether people ate meals with family and friends (conviviality); engaged in physical activity with others, for example by going on walks together; how often they met with family and friends (social habits); and how much sleep they got, both at night and through naps (rest).
After a median follow-up time of 9.4 years, death records were used to compare death rates for cancer, cardiovascular disease and all other causes between those with higher and lower MEDLIFE index scores. The analysis showed the more people adhered to the Mediterranean lifestyle, the lower their risk of dying from cancer or from any cause.
Specifically, compared to those with the lowest MEDLIFE index scores, adults with the highest adherence to the Mediterranean lifestyle had a 29{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} lower risk of dying from any cause and a 28{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} lower risk of dying from cancer. Higher scores for each of the three blocks of the MEDLIFE index were associated with lower cancer and all-cause death risks. Higher scores for the third block, related to lifestyle activities, also were associated with lower cardiovascular death risks.
The study highlights the important roles community and social engagement play in good health, said Marie-Pierre St-Onge, an associate professor of medicine and director of the Center of Excellence for Sleep and Circadian Research at Columbia University in New York City.
“The Mediterranean lifestyle involves interactions with others,” she said, a component that is particularly important for people as they age. Studies have shown social isolation may increase a person’s risk of having or dying from a heart attack or stroke.
The findings emphasize why “we should be paying attention to other aspects of lifestyle, beyond just physical activity,” said St-Onge, who was not involved in the study. “Maybe we need to look at more and more of these social factors.”
One thing the study did not explore and would be of interest in future studies is the impact of stress, she said. “When you think about the Mediterranean lifestyle, you think about living at a slower pace, but this study does not seem to capture that.”
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Kids in the U.S. and around the world are in crisis.
More than 60{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of children with depression don’t get any mental health treatment, according to Mental Health America. Pair that statistic with the fact that about 80{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of the United States has a severe shortage of child psychiatrists, and the picture becomes clear: there is a growing mental health crisis in the United States and beyond.
That’s why CBS News and local CBS-owned television stations spent more than six months exploring the sources of the problem, as well as solutions across the country that could address it. This is a collection of the reporting by CBS journalists, committed to the well-being of our kids.
Documenting kids’ personal struggles
“Bring darkness into the light,” said filmmaker Noemi Weis.
That’s the goal of her documentary, “Connecting the Dots,” which features young people from around the world candidly talking about their struggles with mental health and the need to be supported.
“We need to listen in a way that is with open eyes and with providing a safe space, providing no judgment,” Weis told CBS News. “As much as we believe that we are in a world where we are all connected, the disconnect is huge. The isolation, the loneliness needed to be addressed.”
CBS News licensed the documentary for an exclusive release nationwide on its streaming platforms Wednesday night. The film will be available to view on demand following the streaming event.
The filmmaker created facilitator guides, in partnership with UNICEF, for youth, parents, educators, mental health professionals, and others to watch the documentary and discuss it.
Seeking mental health help
If you or someone you know is in crisis, get help from the Suicide and Crisis Lifeline by calling or texting 988.
In addition, help is available from the National Alliance on Mental Illness, or NAMI. Call the NAMI Helpline at 800-950-6264 or text “HelpLine” to 62640. There are more than 600 local NAMI organizations and affiliates across the country, many of which offer free support and education programs.
Read more from CBS News and local stations
CBS News will continue to update this page as we publish more stories about youth mental health in the coming days.
Fearing Daniel might harm himself, his parents took him to the only place they could: the emergency room. After seven days in the ER, Daniel was discharged; hospital staff felt he was no longer in danger. His parents disagreed. Read more
Young people are increasingly turning to social media platforms like TikTok to diagnose their mental health struggles and often getting misinformation. A California psychology professor has gained a million followers on TikTok by debunking wellness advice that could do more harm than good. Read more
Jamie Howard, senior clinical psychologist at the Child Mind Institute, joins “CBS Mornings” to discuss the youth mental health crisis and shares tips on how parents can have an open conversation with their teens about mental health and social media. Read more
In a city with near daily gun violence, the sound of police sirens and the roar of emergency vehicles often become a part of life in some high-crime areas, leaving the ear-piercing noise nearly ignored. For those young people who are becoming more of the victims of gun violence, their trauma seeps through and is ever-present. Read more
A tragedy in the San Francisco Bay Area was the spark a group of California teens needed to do something about breaking the stigma associated with youth mental illness and how to react in an emotional crisis. Read more
Taking a break from social media – even a short one – can have a powerful impact on the self-esteem of young women. Researchers at Colorado College conducted a study with teenage girls, and found that just three days off social media led to significant improvements in body image. Read more
On a piece of land on Chicago’s West Side, the community group BUILD Inc. has done just that. “We’ve got a whole new building,” said David Rodriguez, a BUILD member. “We’ve got a second floor finally.” Read more
Behind the hustle and bustle of Manhattan, and tucked away beneath another busy school day, there’s a break — 45 tranquil minutes in the basement of New Design High School on the Lower East Side.
It’s where kids forget about calculus and chemistry and clear their minds through yoga. Read more
Chris Hacker
Chris Hacker is an investigative data journalist at CBS News.
Long partial to heavy lunchtime platters of meat and rice, Asim al-Shammari has recently turned to lighter fare from a self-described diet restaurant, swayed by Saudi Arabia’s anti-obesity push.
Roughly one in five Saudi adults is obese, according to an in-depth study published by the World Bank last year that described the problem as “alarming”.
The Global Obesity Observatory places the kingdom at number 17 in its international rankings of obesity prevalence, three slots below the United States and near neighbours Qatar and Kuwait.
But the Vision 2030 reform agenda spearheaded by Crown Prince Mohammed bin Salman includes goals for bringing down both obesity and diabetes by the decade’s end.
The effort is being helped by a raft of new restaurants offering healthier alternatives to some traditional Saudi fare, including the spot where al-Shammari, a financial analyst, tucked into a plate of chicken, rice and carrots one recent afternoon.
“I used to eat burgers, shawarma or kabsa while I was at work,” said the 28-year-old, referring to a rice dish usually served on large shared plates.
“This increased obesity, especially with eight-hour office work and lack of movement.”
Lifestyle changes
For decades, Saudis have spent much of their free time in restaurants and shopping malls, and food was a chief source of entertainment in the kingdom, where high temperatures limit outdoor activities for much of the year.
In 2019, the health ministry started requiring restaurants to include calorie information on menus to encourage healthy eating.
Fast food options – from international favourites like McDonald’s to local chains like Al Baik – remain ubiquitous in the kingdom’s main cities, but they are starting to face more varied competition.
Saad al-Hader, a 25-year-old doctor, said he used to bring meals from home so he could eat something besides junk food, but the proliferation of new health-conscious eateries has made his life easier.
“The popularity of these restaurants and the fact that they are close to workplaces, makes it easier to stick to healthy eating,” he told AFP as he dined on salmon and grilled potatoes.
A growing number of restaurants are offering meal plans that send salads and other healthy meals to clients’ homes and workplaces.
One such plan provides a meal a day for a month for 450 Saudi riyals ($120).
Basil Chehayeb, a Lebanese national who runs a restaurant called Reshape in the Saudi capital Riyadh, said he had opened two new branches in the past 18 months to keep up with demand.
The restaurant provides meals each day to about 500 subscribers, most of whom are Saudis.
“Saudis have changed their lifestyle and are now attending sports clubs and eating healthy foods,” he said.
Targeting the youth
Efforts by restaurants and other private sector businesses to promote healthy eating have been supplemented by other health-minded interventions.
The Saudi Sports for All Federation now organises regular events like the Riyadh Marathon, which this year drew thousands of runners to the streets of Riyadh.
Officials have also begun work on a 135-kilometre (85-mile) Sports Boulevard in the capital featuring foot, cycle and horse-riding paths.
Beginning with the current academic year, the Saudi health ministry has banned the sale of soft drinks in schools.
The message seems to be getting through, at least among young people, said public health consultant Lamia al-Brahim.
“Obesity is a serious health problem” but “it is very noticeable now that health awareness is increasing among the young generation,” she said.
“Societal behaviour changes need a long time, and these efforts start from within the home, then the school and then the government agencies.”
This story includes discussions of suicide. If you or someone you know is in crisis, you can get help from the Suicide and Crisis lifeline by calling or texting 988.
While most kids his age were wrapping up their junior year of high school, Daniel was in a box.
“It was like I was sitting in a gigantic FedEx box being shipped somewhere,” he said. “But like, add one bed and the door had to be closed at all times.”
Daniel’s years of mental health struggles, stretching back into his early childhood, came to a head in early 2022. His often-uncontrollable emotional outbursts became unmanageable; he was “unraveling,” his parents said.
CBS News is only using the first names of former patients interviewed for this story to protect their privacy.
Fearing Daniel might harm himself, his parents took him to the only place they could: the emergency room. After seven days in the ER, Daniel was discharged; hospital staff felt he was no longer in danger. His parents disagreed.
“We were like no, no, no, he is so not ready,” his mom Kathe said. “We’ve been waiting and waiting, but he is not ready.”
Daniel’s therapist even wrote a letter to the hospital saying he wasn’t ready to be released. But the hospital said he needed to go home.
Ten days later, he was back in the ER — this time at another nearby hospital, where he would stay for 19 days.
“There’s barely any room in the [hospital] room to walk around,” Daniel, now 18, said. “So I was just sitting on my bed all of the time. I had some rough times there, like it was really difficult to, like, stay put, you know, and that’s what they expected [me] to do.”
Read more: Inside America’s youth mental health crisis
Instead of the intensive mental health care he needed, Daniel said he got very little help while in the room.
“Dan, rightfully so, he was like, what am I doing here?” Kathe said. “This is not help. You promised help. Where’s the help?”
“Severe shortage”
Stories similar to Daniel’s are growing more common in the U.S., fueled by a critical shortage of doctors, therapists and resources to address the needs of kids in crisis.
In Massachusetts, the number of kids landing in ERs for mental health treatment soared 200{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}-400{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} during the pandemic. That same trend is reflected across the country: a 2021 study found the number of kids stuck in ERs awaiting treatment tripled between 2019 and 2021.
“I do think it is very bad,” said Dr. Muniya Khanna, research scientist at Children’s Hospital Philadelphia and a former faculty member at the University of Pennsylvania’s Department of Psychiatry. “Suicide is now the number two leading cause of death in children 10 to 24. And this trajectory is only getting worse after the COVID pandemic. And so, we are absolutely in a crisis.”
Experts say it’s a demand and supply issue: demand for mental health services has increased after the pandemic and the supply of trained staff hasn’t increased enough to fulfill the needs.
Forty U.S. states and Puerto Rico all have “severe” shortages of child psychiatrists, according to data from the American Academy of Child and Adolescent Psychiatry (AACAP) analyzed by CBS News. Only the District of Columbia reported having enough child and adolescent psychiatrists to meet AACAP standards.
RELATED: Half of all Texas school districts have no mental health services
Amid this lack of formal mental health treatment options, ERs have become the last and only option for many families, according to numerous mental health experts interviewed by CBS News.
“Kids languish for days, weeks, sometimes even over a year in children’s hospitals around the country,” said Zach Zaslow, vice president of advocacy and community health at Children’s Hospital Colorado. “This is not just a Colorado problem, and it happens because there’s nowhere else that’s safe for them to go.”
In Colorado, Michaela, who grew up in foster homes, told CBS News she tried get a special therapist to address her anger, anxiety and depression nearly a dozen times.
“I would be crying out for help,” Michaela said. “I would say I need support. And it wouldn’t happen until I came to a point where it was too late to really come back and not make a bad decision that in the end would hurt me.”
Michaela said she tried to hurt herself, including several suicide attempts, over those years. She said the system in its current form does not do enough for young people until they reach a crisis point.
“I think it’s really hard to get into a good therapist or just a therapist in general,” Michaela said. “It doesn’t matter if they’re good or bad.”
Michaela said she had a total of eight ER visits for mental health crises, and often left the ER without seeing a therapist. The few times she did meet with a mental health expert, she said her therapy was cut short.
“It did cause me to have to go back [to the ER] again like less than a year later just because I didn’t get the help that I needed,” said Michaela. “And I think it was partly because I left too early.”
Michaela, who is now 20, said she is proud that she’s “beat the odds” and survived. She now sits on a youth advisory board as part of a partnership between the University of Colorado and Children’s Hospital Colorado.
“It definitely made me feel like all of that pain and suffering that I had to go through wasn’t a waste,” said Michaela. “Because now I can be the voice of power for so many other young people who are stuck in the same situation that I was and give them hope that I didn’t have then.”
A revolving door at ERs
Experts told CBS News the use of ERs as stopgap mental health treatment measures simply doesn’t work.
“For anybody who’s been in an emergency department for more than a few hours, it is not an ideal place to be,” said Dr. Kevin Carney, an emergency room physician at Children’s Hospital Colorado.
Massachusetts General Hospital in Boston, where Daniel stayed for 19 days, acknowledged the problem, saying in a statement to CBS News that “shortages [of proper mental health treatment options] have forced youth in crisis — and their families — to turn to their local emergency departments where ongoing capacity challenges may mean waiting for days or weeks for appropriate inpatient care to become available.”
For kids in crisis, ER visits can make matters even worse.
A December 2022 American Academy of Pediatrics study found more than a quarter of children who went to ERs for mental health issues were hospitalized — either in ERs or in mental health facilities — within six months. And about 26.5{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} were back in the ER within a week.
Dr. Sandra DeJong, a psychiatrist and the secretary with the American Psychiatric Association, said if kids don’t get proper care early, their condition can rapidly get worse.
“My fear is that we really have significant risk for the future,” DeJong said. “Because if we don’t address the needs of particularly young people now, then they are going to grow up to be people who are diminished and don’t have the capacity to function in the way that they could have if they had gotten the treatment.
“And frankly, they’re going to be expensive to care for because if they go untreated, there are situations that are likely to get worse and then they will need higher intensity care. It’s just not an effective way to approach the problem.”
Meanwhile, more and more kids find themselves in crisis. Suicide attempts by teen girls jumped more than 51{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} between 2019 and 2021, according to a study by the CDC. And a recent study published in the journal JAMA Pediatrics found the number of suicide attempts by overdose reported to poison control centers more than doubled between 2000 and 2020.
The number of kids with mental health issues coming to the ER “has been unrelenting,” said Zaslow.
“And it’s not acceptable,” he added. “It means ultimately, at the end of the day, that there are kids waiting for those beds every single minute as soon as one frees up.”
Dr. Taylor Louden, medical director at Cook Children’s Medical Center in Fort Worth, Texas, said that in recent years he’s seen more and more young patients come into his ER for mental health problems.
“We are seeing even younger and younger kids, 8-, 9-year-olds — ages of my kids,” said Louden. “Some are expressing that they want to hurt themselves that they want to die and it’s really tough to hear.”
Not only are there more kids showing up in ERs, Louden said, but they’re staying longer, too.
“No one should ever be in an ER longer than a few hours,” he said. “That means that the system is broken, in my mind.”
Inside an ER’s psych room
04:04
“It’s not acceptable”
Numerous experts CBS News interviewed said serious investments are needed to increase the mental health resources available to kids in crisis.
CBS News went to the person in charge of the system in the U.S.: Health and Human Services Secretary Xavier Becerra, who said “we have to do a lot” to fix the problem.
“It wasn’t until recently that you could get an insurer who actually gave you access to mental health services,” Becerra said. “And we still have a system where mental health is what you get at a primary care physician when you go to a family doctor.
“That’s got to change. Mental health, it’s got to be part of primary health, not something where you get a referral to a specialist.”
When asked about children getting stuck in ERs rather than proper mental health treatment facilities, Becerra said it was “not acceptable.”
“It’s not care,” Becerra said. “It’s housing them until we can get somebody who could give them professional help. They’re crying out and shame on us that we haven’t prepared.”
Becerra pointed out that several states and the federal government are investing billions of dollars into mental health care. And last summer, the Biden White House announced $300 million to expand mental health services in schools.
“That’s where the president last year in the State of the Union and again, double down this year has said, Congress, we’ve got to step up, we’ve got to finish the job of making sure that mental health is treated like any other aspect of health,” Becerra said.
But doctors Khanna and DeJong both said much of this federal spending comes in the form of one-time grants that will eventually expire.
“Now it’s really time to start investing time and resources on all levels for making that happen more on a regular basis,” said Khanna.
Attracting more people to work in youth mental health must be part of the equation, DeJong said.
“You can build all the beds and clinics in the world,” DeJong said. “But if you don’t have enough people to staff them, which is a real problem right now, we’re not going to meet the needs that we’re facing.”
Secretary Becerra agreed.
“You just got to put your money where your mouth is. And President Joe Biden is trying to put his money there,” Becerra said. “We need now the partnership with Congress to make it happen.”
HHS Secretary Xavier Becerra speaks about youth mental health crisis
06:53
Some aren’t waiting on the federal government to help, instead trying new approaches in attempts to address this crisis and meet young people where they are.
One of those approaches comes in the form of a youth advisory group at Children’s Hospital Colorado. The advisory group consists of teenagers who regularly meet to give advice to therapists and hospital officials about how to meet the needs of young people.
Another new approach: construction of a new, first-of-its-kind facility at the Cherry Creek School District outside Denver that will combine a mental health medical facility and a school when it’s completed in the fall of 2023.
When kids in crisis leave ERs
Finding help after a hospital stay can be even more challenging.
The Academy of Pediatrics study found just 31.2{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of children had a mental health follow-up visit within seven days of leaving the hospital and only about half had a mental health follow-up with a specialist within 30 days of leaving the hospital.
“I think what is very distressing about this mental health crisis that we’re facing is that while we very much take as part of our responsibility to make sure that we are keeping kids safe and stabilizing them when they’re in crisis or have harmed themselves,” Dr. Carney said. “The very hard thing is knowing that at that point I can’t do anything else for that child.”
Dr. Glenda Wrenn Gordon knows those statistics firsthand: she and her 18-year-old son lived them.
Wrenn Gordon said even though she’s an Atlanta-area psychiatrist herself, she was surprised by the effort she had to put in to find help for her son in crisis after she got him to the ER. She said she thought she knew what to do, but still found the system of finding and getting care post-hospital visit to be daunting.
“We moved very quickly through the ER because I knew exactly what to say and how to say it to get us where we needed to go,” she said. “I was extremely frustrated for how hard it was. I was thinking about these other families. What hope do they have and what it must be like?”
When asked what she fears most if the system is not changed, Wrenn Gordon was blunt.
“We will continue to bury our children,” she said.
Atlanta psychiatrist struggles to find help for her son
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If you or someone you know is in crisis, get help from the Suicide and Crisis Lifeline by calling or texting 988.
In addition, help is available from the National Alliance on Mental Illness, or NAMI. Call the NAMI Helpline at 800-950-6264 or text “HelpLine” to 62640. There are more than 600 local NAMI organizations and affiliates across the country, many of which offer free support and education programs.
