'This is unprecedented': Kids in need of mental health treatment often wait days, weeks in ERs at Minnesota hospitals

Cases of children facing mental health crises have surged over the last year in Minnesota, with many waiting days or weeks in ill-equipped hospital emergency departments before they can receive appropriate treatment, the Star Tribune reported May 17. 

Holding psychiatric patients in EDs until a hospital bed becomes available, a practice known as "boarding," is nothing new, but amid new levels of stress stirred by the pandemic, it's reached a breaking point, according to hospital administrators and child psychologists. 

"The water was already high, and now the dam has broken," Kristen Wiik, PhD, manager for neuropsychology and the child and adolescent psychiatry clinic at Minneapolis-based Hennepin Healthcare, told the Star Tribune. 

While pediatric mental health disorders were left untreated amid earlier stages of the pandemic, many of the state's ER departments are now reporting a surge in such admissions. 

At Minneapolis-based M Health Fairview, one of the state's largest health systems, ED visits among children and adolescents facing mental health crises have jumped 18 percent this year compared to before the pandemic. 

As many as 20 children are "boarding" across the health system on any given day as they wait for inpatient beds, where they can receive more intensive care, officials told the news outlet. 

"This is unprecedented," said Allison Holt, MD, physician chief for mental health and addiction at M Health Fairview. "Whenever you have 20 kids waiting in an emergency department for more than a couple of hours, that's a crisis." 

Most children boarding across the health system's EDs are discharged within days, though in one case, a child waited eight months for a bed at a residential treatment center, according to the report. 

In response, hospital systems including M Health Fairview have started assembling multidisciplinary task forces to address the boarding issue, though ED demand often hinders the teams' ability to respond. 

Waiting for an ED bed in a chaotic environment often triggers or aggravates symptoms in children facing a mental-health related crisis. Experts worry a traumatizing experience could have long-term effects, such as deterring them from seeking care in the future. 

"I worry that, if a child's very first experience with the mental health system is traumatic, then will they never go back?" asked Karen Malka, a schoolteacher whose 16-year-old daughter had to wait 74 hours in the emergency room at Minnesota hospital before receiving further care. "Will they ever seek help again?," she told the Star Tribune, adding that while boarding, her daughter, who was severely depressed and suicidal, heard a man yelling profanities and saw another man leave his ER room naked. 

To read the full Star Tribune article, click here


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