Mental health state of emergency for children and adolescents
On Oct. 19, the American Academy of Pediatrics and other national organizations declared a state of emergency around the mental health of children, adolescents, and their families. Citing the impacts of the pandemic, racial injustice, and trends that existed prior to the pandemic, they called for immediate action to alleviate this crisis. New Hampshire youth are not immune to this crisis. The staff and volunteers at NAMI New Hampshire (National Alliance on Mental Illness) hear nearly daily from parents of children who cannot access timely mental health crisis care and, far too often and for too long, are waiting in emergency departments, waiting for an inpatient psychiatric hospital bed.
Since the start of the pandemic, New Hampshire, like the rest of the country, has seen soaring rates of stress, anxiety, and depression among children, youth, and young adults. The most visible sign of this is the number of young people in an acute mental health crisis requiring inpatient care, who are being boarded in emergency rooms across the state. The number of children waiting each day has more than tripled since the start of the pandemic in March of 2020 – averaging this month at around 22 children each day. When those numbers reach the high teens, it may be two to three weeks before an inpatient bed becomes available. This process is traumatizing to children and their families, and places considerable strain on already short-staffed Emergency Departments.
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Governor Sununu, with unanimous support from the Executive Council, is taking a major step forward to address current and future inpatient capacity for children by moving to purchase Hampstead Hospital which currently houses the only children’s inpatient mental health unit in the state. The purchase of Hampstead Hospital and its large campus also offers the potential to expand acute services for children’s mental health including an adolescent psychiatric residential treatment facility, as well as the continuum of services and supports outlined in NH’s 10-Year Mental Health Plan and recommended in the AAP’s declaration of the state of emergency for children’s mental health.
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The declaration by the AAP also addresses the issue of teen suicide, specifically mentioning rising rates among teen girls and young people of color. In NH, suicide is the second leading cause of death for ages 10-34. This, combined with the impact of the pandemic upon young people, makes our collective efforts to address the needs of our youth all the more urgent. New Hampshire has just this year taken important steps to address suicide prevention – establishing a State Suicide Prevention Coordinator, tasked with supporting the legislatively established State Suicide Prevention Council, whose charge is to facilitate implementation of the New Hampshire Suicide Prevention Plan, and allocating $100,000 a year in funding to support those suicide prevention initiatives.
In addition, this week, NH began requiring the use of the 603 area code for dialing instate phone numbers – another positive step toward dramatically improving mental health crisis care. Federal legislation signed by President Trump calls for replacing the current 1-800-273-8255 National Suicide Prevention Hotline with a 3-digit number, 988, which will go live in July of 2022. The recognition that the new 988 number will be more than just a suicide prevention hotline, but also a mental health crisis line, is transforming mental health crisis care here in New Hampshire and across the country. Come January, New Hampshire will have a statewide centralized mental health crisis call system and the ability, if needed, to deploy mobile mental health crisis response teams to all regions of the state. Both the centralized call center and mobile crisis teams will dramatically improve timely access to mental health crisis care for Granite Staters of all ages – offering individuals and families experiencing a mental health crisis alternatives to calling 911 or going to the Emergency Department.
Although New Hampshire is making some positive gains addressing the children’s mental health crisis, there is still a great deal of work to be done – much of which is highlighted in the recommendations in the AAP’s emergency declaration. Workforce shortages are having negative impacts across New Hampshire, resulting in excessively long waits for outpatient care for children and youth. Schools need to have effective models of mental health care, including continuing to move forward with implementing K-12 social emotional learning curricula as recommended by Governor Sununu’s 2018 School Safety Task Force. Mental health needs to be better integrated into pediatric primary care settings and trauma-informed care needs to be embedded across all areas of the child services delivery system. And as New Hampshire expands its children’s mental health system of care, health insurance companies need to reimburse for community-based services like in-home supports and mobile crisis response which can prevent more costly interventions like hospitalization.
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While talk of what divides us seems to dominate every news cycle, Granite Staters are united in our belief that children’s mental health matters. Let’s work together and continue to make children’s mental health a Granite State priority!
Ken Norton is the executive director of NAMI-NH.
This article originally appeared on Portsmouth Herald: Ken Norton: Mental health state of emergency for children and adolescents
