Lack of access to mental health care is a crisis for patients of all ages

A crisis has been declared

There was a 24% increase in emergency department (ED) visits for mental health-related reasons amongst children ages 5 to 11 in U.S. hospitals in 2020 in 2020 in comparison with 2019. Teen visits to U.S. emergency departments for mental health mental health increased by 31% year-on-year, the study found Children’s Hospital Association. The Children’s Hospital Association also notes that hospital admissions and ER visits suicide attempts doubled between 2008 and 2015.

The COVID-19 pandemic has exacerbated this trend, said Laura J. Wood, DNP, RN, NEA-BC, FAAN, executive vice chairman of patient care operations, system chief executive officer and chief nursing officer of Sporing Carpenter at Boston Children’s Hospital.

“For children and adolescents, what began as a pandemic focused on an infectious disease has evolved into a mental health crisis of unprecedented proportions,” Wood said.

In October 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association declared a pediatric mental health emergency, citing the severe toll of the Covid-19 pandemic in addition to existing challenges reminiscent of a rise in suicide rates pre-Covid -19.

Mental health is a component of holistic health, said Lindsey Casey, MSN, RN, NEA-BC, senior vice chairman and CEO of Children’s Hospital of New Orleans.

Lindsey Casey, RN

“While the pandemic has focused much of our attention on the physical health of our community, we cannot lose sight of the mental health implications that significantly impact the pediatric population,” Casey said. “The statistics are alarming. According to the CDCCompared to 2020 and 2019, the number of suspected suicide attempts increased by 51% for girls aged 12 to 17.

Adults suffer too. One in three people reported symptoms of an anxiety disorder in 2020, up from one in 12 in 2019, according to a 2020 American Hospital Association study. November 15, 2021, later in response to a request from the Senate Finance Committee for information on behavioral health care in the United States

The increase in mental health issues should come as no surprise, given the pandemic’s physical isolation, ongoing uncertainty, fear and sadness.

They fight to ensure access to mental health care

The pandemic has changed traditional models of care in mental health care.

“During the COVID-19 pandemic, community support systems such as schools, neighborhood recreation centers, after-school programs and school resources such as school nurses quickly disappeared with the advent of mandatory stay-at-home declarations,” Wood said. “As a result, families with children and young people in crisis have turned to emergency care facilities, including children’s hospitals, in unprecedented numbers. The number of children and adolescents requiring inpatient care quickly filled child and adolescent mental health facilities and dwarfed the capacity of children’s facilities. hospitals across the country.”

According to Connie Vogel, MD, RN, CNE, who’s a school member at Capella University’s School of Nursing and Management, psychiatric hospitals have been hit extremely hard by the pandemic and the necessity to take care of restrictions around mask-wearing, social distancing and cleanliness. Health Sciences.

Imagine a patient becomes aggressive, Vogel said. “Maintaining the safety of this person, other patients and staff is difficult even in the best of circumstances. “When you add concerns about direct contact due to COVID-19, it makes it extremely difficult to manage destructive behaviors and maintain one-on-one suicide precautions,” Vogel said.

While schools and community mental health resources have reopened for now (the impact of the most recent Omicron variant on Covid-19 stays unknown), there are supply and demand issues.

Mental health providers, including mental health nurses, are briefly supply and vulnerable to burnout. Like the overall population, health care providers caring for the mental health needs of patients are succumbing to fear and stress related to the pandemic because access to mental health care doesn’t meet the growing mental health needs of the community.

“For individuals with ongoing behavioral health and substance abuse issues, one of the most serious impacts was the reduction in direct contact with providers, counselors and groups that provided ongoing support and helped individuals maintain balance,” Vogel said.

Adults in the overall population also report mental health problems related to high stress. American Psychological Association’s “Stress in America: A National Health Crisis” report suggests that 78% of adults said their stress and stress responses, reminiscent of sleep disturbances and anxiety, have increased resulting from the pandemic crisis, Vogel said.

Maria Ingalla, DNP, PMHNPBC, PMHC, owner and practitioner at Paperflower Psychiatry in Phoenix, Arizona, and professor of mental health nursing at Arizona State University, said she has been seeing more patients with acute suicidal thoughts because the starting of the pandemic.

“There has been an increase in the number of young children at school who are having suicidal thoughts. “I think a lot of it is because kids are being forced to go back to school now after a year off,” Ingalla said. “This has resulted in a greater increase in the number of patients coming to us because there is so much public anxiety right now.”

A letter from the American Hospital Association found that America is ill-prepared to fulfill society’s mental health needs resulting from severe shortages of behavioral medical examiners.

“More than 100 million Americans live in areas where there is a shortage of psychiatrists…. For hospitals and health systems, the pandemic has exacerbated existing behavioral health challenges, and many hospitals have been forced to reduce behavioral health staffing due to pressures. budget, “according to the American Hospital Association.

Add to this that the number of state-funded psychiatric beds per capita declined by 97% between 1955 and 2016, which, according to the American Hospital Association, resulted in a sharp increase in emergency department visits for behavioral health services.

Nurses seek solutions through advocacy

According to Wood, nurses play a critical role in providing children with much-needed access to mental health care and supporting this population.

“Nurses can help parents acknowledge childhood stress and vulnerabilities and refer children to sources of support more quickly,” Wood said. “Strong and connected family relationships can significantly mitigate the risks that children and young people experience during times of high stress.”

Wood said nurses have gotten increasingly involved in public policy efforts to enhance the mental health of youngsters and adolescents within the U.S., reminiscent of:

• Increased reimbursement for screening and preventive mental health services in primary care are most frequently not or underreimbursed by business and government payers
• More effective training for advanced practice registered nurses (APRNs), pediatricians and other primary care providers on early mental health risks, identification and screening
• Educational sessions to have interaction parents and college staff on appropriate early identification of youngsters in danger, other ways to get help and effective engagement of faculty staff
• Greater support for federal initiatives to encourage state and native municipalities to adopt recommendations Healthy students, promising future

Changes may come

In September 2021, Senate Finance Committee Chairman Ron Wyden, D-Ore., and Finance Committee rating member Mike Crapo, R-Idaho, attempted to develop bipartisan laws to remove barriers to access to mental health care.

As a part of this motion, they sent, amongst others: letter behavioral health care stakeholders and others requesting input on policy development.

Wyden and Crapo wrote that their goal is to develop laws that addresses the various behavioral health care challenges that hundreds of thousands of Americans currently face.

The Letter from the American Hospital Association provides recommendations for strengthening the mental health workforce, which incorporates addressing reimbursement issues and techniques to scale back burnout. It also recommends strengthening student loan forgiveness programs to support training for behavioral health professionals in any respect levels and promoting efforts to scale back variability in scope of practice regulations and support further changes.

” [American Hospital Association] Supports streamlining the licensing and credentialing process for federal programs and promoting interstate licensing agreements for physicians and allied health professionals,” the letter reads.