Some children with mental illness spend months in Michigan emergency departments

Michigan’s health care system will soon receive $50 million in state funding for inpatient psychiatric care for children with acute mental illness.

But experts say it has become a mental health safety net in the state as hospitals continue to struggle to cope with the large number of children being rushed to emergency departments with serious mental health problems. He said more needs to be done to repair the large holes.

U.S. Centers for Disease Control, Division of Youth and School Health

Laura Appel is executive vice president of government relations and public policy for the Michigan Health and Hospital Association.

In addition to mental health conditions, many of these children have developmental disabilities such as autism, she said, and once they go to the emergency room, they often have nowhere to go.

That’s because most hospitals in the state don’t have inpatient pediatric psychiatric units, and there’s a lack of treatment options in children’s accommodation. Once the children are stabilized, sending them home is often out of the question. That’s because home care agencies generally can’t find enough people to train families to care for their children.

Therefore, children must remain in the emergency department.

“When you’re in the emergency department for days, if not months, you’re going to have more problems than you started with,” Appel said. “At every major hospital in Michigan, there is a story of a child who has been in the hospital for weeks and months. I mean, because it’s very difficult to entrust children with such complex needs.”

Appel said he hopes some of the $50 million state funding will go toward creating a pediatric residential care facility. She also said staff-level, intensive-care-style hospitalization, with one nurse for one or two patients, is also needed for the most severely affected children.

But Appel also said state health care systems need to receive appropriate treatment for children’s mental health needs to prevent them from succumbing to ED in the first place. This will require schools, primary care physicians, outpatient mental health professionals and community mental health agencies to pay more attention to the mental health status of children.

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