With Minnesota kids in crisis and fewer mental health professionals available, more are turning to ERs

MINNEAPOLIS — As one of the largest children’s mental health service and training providers in Minnesota, the Washburn Center for Children is a kind of first-line of defense for kids and families, and CEO Tom Steinmetz spoke to reporter Kent Erdahl about the difficulties they are facing.

Steinmetz: “Our goal is to provide mental health care that is equitable, high quality and easily accessible to families where and when they need that.”

Erdahl: “Are you able to achieve that goal right now?”

Steinmetz: “Right now, being able to respond and meet the need that we are seeing is very, very difficult. I know, as a parent, more than anything you want to know that your child is safe and healthy and happy, and for them to not be able to get the care and the help and support that they need is just an unacceptable reality in Minnesota today.”

He says the reason for that reality is two-fold. He says staffing is off by about 10{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d}, at a time when demand is off the charts.

Steinmetz: “We’re facing the most severe mental health workforce crisis that I have seen in my 25 years at Washburn. In terms of demand, to give you an idea, when kids went back to school in April, we had openings in almost every type of service that we provide. Pretty quickly after kids returned to school, the phones started ringing off the hook and we reached a place where we quickly had 700 families on our waiting list. So that’s 700 families that are trying to access mental healthcare that we simply don’t have capacity to serve.”

And with nowhere else to turn, many kids and their families are turning to emergency departments.

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According to a new Advisory by Attorney General, Dr. Vivek Murthy, in early 2021, emergency department visits in the United States for suspected suicide attempts were 51{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} higher for adolescent girls and 4{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} higher for adolescent boys.

Locally, the numbers aren’t much better.

“We’ve seen roughly a 30{b574a629d83ad7698d9c0ca2d3a10ad895e8e51aa97c347fc42e9508f0e4325d} increase overall in the number of kids coming into our emergency departments for mental health reasons,” said Jamie Winter, Director of Behavioral Health at Children’s Minnesota.

Winter says Children’s Minnesota is also dealing with a shortage of mental health staff, meaning those trips to the ER often take days to resolve.

Winter: “We do prioritize kids with mental health concerns to at least get that initial evaluation. Where we see the wait come in is if the determination is made that they need to be in the hospital and there are no hospital beds available for mental health in our community, we sometimes see kids who will board – or wait – and that can be anywhere from a day, to a week or even greater at times.”

Erdahl: “A week, essentially tying up a bed in an emergency department?”

Winter: “Absolutely. So on any given day we have anywhere from five to 10 kids who are really in that holding pattern waiting to go to an appropriate level of care. It really makes it challenging because it prolongs the wait for care for all kids.”

And that backlog for Crisis care is making healthcare disparities worse. According to the Surgeon General’s advisory, Black children are nearly twice as likely to die by suicide as white children, and they are also more likely to lose a parent or caregiver to COVID.

Locally, Winter says they are also seeing a greater share of Black children coming to the ER in crisis. In response, Children’s Minnesota plans to open it’s first ever in-patient acute care unit for mental health in 2022.

Steinmetz says any expansion of care is important, but he says it will take a lot more support, a lot earlier, to change the course of this crisis.

“Our partners at places like Children’s Hospital and Allina do a remarkable job of supporting families in that situation, but that’s not what emergency departments are intended to do,” he said. “You have a child who is terrified, they may be having a traumatic response, they are overwhelmed with anxiety or depression and they are going in to get help in the most intensive part of the system.

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We know that children’s mental health issues were the most common and most costly health conditions of childhood even before the pandemic, and yet we had over 100,000 children in Minnesota living with untreated mental health challenges before the pandemic. I don’t even know what that number is today.”

“Would we accept that reality for any other childhood health condition? I don’t think so. We would never say to 100,000 kids, who had broken their arm and are living with that pain, you’re just not going to get help. What we need now is an investment in mental healthcare that reflects how severe this crisis is.”

though it can be really difficult to find care right now, Steinmetz stressed that families should not give up trying, especially if you’re dealing with a crisis.

If you’re a Minnesotan in need of mental health support for a child, contact the Washburn Center for Children 612-871-1454

Due to COVID-19 restrictions, some Washburn Center’s services continue to be offered via telehealth (virtual/web-based). Some programs are beginning to return to in-clinic settings with safety and wellness requirements. To learn what program is right for your child and family, call the intake number above.

If this is an emergency dial 911 or for adult crisis call Hennepin County Acute Psychiatry at 612.873.3161 or for child crisis call Hennepin County Child First Response at 612.348.2233.

Here are some additional resources for people facing a mental health crisis.

Crisis Text Line – text “MN” to 741741 (standard data and text rates apply)