Speaker 1: It's Thursday. I'm oscar A Mirrors from the Daily Dive
Speaker 1: podcast in Los Angeles, and this is reopening America. The
Speaker 1: demand for mental health care has overwhelmed supply for most
Speaker 1: of the pandemic, and in some places like Massachusetts, the
Speaker 1: need for those services is critical. If traditional hospitals and
Speaker 1: treatment centers don't have available space for mental health services,
Speaker 1: some may need to go to the e er in
Speaker 1: what is known as emergency room boarding for psychiatric patients.
Speaker 1: These types of stays have risen between two hundred and
Speaker 1: four percent in Massachusetts during the pandemic, and e r
Speaker 1: s are not equipped for this type of treatment. Martha b. Binger,
Speaker 1: healthcare reporter at w bu R, joins us for what
Speaker 1: to Know and one girl seventeen days stay in an
Speaker 1: e er. Thanks for joining us, Martha, thank you for
Speaker 1: having me. I'm gonna talk about an interesting piece you
Speaker 1: wrote about kids and with mental health crisis is right now.
Speaker 1: A lot of times hospitals are overrun, they don't have
Speaker 1: enough space, and sometimes these kids have to go into
Speaker 1: e r s and in some cases they can be
Speaker 1: there quite a quite a long time. You profiled a
Speaker 1: girl named Melinda who had to spend seventy seventeen days
Speaker 1: in an e ER just really not the right setting
Speaker 1: for what she was going through. But because of y
Speaker 1: issues other places where she couldn't be placed, you know,
Speaker 1: she had kind of tough it out through there. So
Speaker 1: Martha tell us a little bit about her ordeal and
Speaker 1: and the overall problem with uh, you know, staying in
Speaker 1: the e R s but e R boarding as they
Speaker 1: call it, right, So Melinda has anxiety and depression that
Speaker 1: really got worse during the pandemic as she grew more
Speaker 1: and more isolated. You know, her her saying lessons stopped.
Speaker 1: She was going to school virtually, she was seeing therapist,
Speaker 1: but that all switched to virtual sessions as well, and
Speaker 1: she just wasn't connecting. So she had four trips to
Speaker 1: the e R starting last December, in instances where she
Speaker 1: threatened to kill herself, and the one where she ended
Speaker 1: up spending seventeen days in the e ER started in April.
Speaker 1: What happened was she got there and all of the
Speaker 1: psyche beds for kids in Massachusetts and surrounding states were full.
Speaker 1: Because we're seeing a lot of increasing demand for mental
Speaker 1: health care and and really extreme cases where where children
Speaker 1: are threatening to harm themselves, and so all of the
Speaker 1: units are full. And in addition, during COVID, many of
Speaker 1: the psyche beds have been converted to to COVID where
Speaker 1: they needed them, or they had been switched from double
Speaker 1: rooms to single so there was there was kind of
Speaker 1: a shrinking of of space that for to take care
Speaker 1: of these kids with psychiatric needs and more demand, and
Speaker 1: Melinda ended up kind of caught in that bottleneck, waiting
Speaker 1: seventeen days to be placed in a bed. You know,
Speaker 1: in a lot of time, there's an individual a lot
Speaker 1: of individual care that these patients need, and Melinda wasn't
Speaker 1: getting that for her first ten days in the hospital.
Speaker 1: Was kind of I guess you described this lecture hall
Speaker 1: with a dozen other kids on gurneys, is just separated
Speaker 1: by curtains and whatnot, and it's just tough to get
Speaker 1: kind of get the treatment that you need. By the
Speaker 1: time you caught up with her, she was already in
Speaker 1: there for twelve days in the e er. Tell me
Speaker 1: how that went well. She wasn't getting any care in
Speaker 1: the e er, But that's not unusual emergency rooms. They're
Speaker 1: kind of the place where you just assess the problem
Speaker 1: and then move on. So you know, if you break
Speaker 1: your arm, they might fix that in the emergency room.
Speaker 1: If you have a heart attack, they're very likely going
Speaker 1: to move you up to someplace in the hospital where
Speaker 1: you can get care for that. But if you have
Speaker 1: psychiatric need and there's no space, you just sit there
Speaker 1: because emergency rooms aren't set up to provide any therapy,
Speaker 1: any psychiatric analysis, anything like that. And so Melinda just
Speaker 1: started to spiral downward, you know. She she eventually got
Speaker 1: moved out of that lecture hall into a small room
Speaker 1: off of the emergency room. But again, like she was.
Speaker 1: She she was sitting on a gurney, no furniture in
Speaker 1: the room, wasn't allowed to have her phone except for
Speaker 1: maybe an hour a day. Um, she she wasn't getting
Speaker 1: any treatment, so she just got worse and worse, which
Speaker 1: meant that she had some behavior problems. She was screaming
Speaker 1: at staff sometimes, she threatened to escape one time, and
Speaker 1: that it made her harder to place. So it turned
Speaker 1: into this kind of catch twenty two because the hospitals
Speaker 1: didn't want this girl who was acting out, but she
Speaker 1: was acting out because she had been stuck in the space.
Speaker 1: You were also able to make contact with her mother, Pam.
Speaker 1: And you know, as the days were progressing, you know,
Speaker 1: she said, the longer that her daughter Melinda is there,
Speaker 1: the more she's starting to decline. And basically what you
Speaker 1: were just describing, she was lashing out, and and that
Speaker 1: just complicates everything from then on out. Yeah, I mean, Pam,
Speaker 1: Pam could see that, um, other children who were more
Speaker 1: docile than her daughter were getting placed more quickly. Um,
Speaker 1: people who didn't complain seem to be getting placed more quickly.
Speaker 1: But the and the hospital administrators will tell you, look,
Speaker 1: we have to sort of assess who's coming in to
Speaker 1: be sure they were going to be a good fit
Speaker 1: for a program. We don't want to take in somebody
Speaker 1: who we think is going to kind of disrupt the
Speaker 1: care that we're trying to provide for other people in
Speaker 1: the unit. But it it becomes a very difficult situation
Speaker 1: for for mental health patients who aren't you know, quote
Speaker 1: unquote well behaved. Milinda and Pam, we're both doing like
Speaker 1: audio diaries, so we're able to kind of hear from
Speaker 1: Melinda and her own words what was going on. And
Speaker 1: she said that she wished in a lot of cases
Speaker 1: that someone would just understand her she really couldn't get
Speaker 1: across anybody how bad things were for her. Yeah, No,
Speaker 1: she's she's had a very hard time, um what during
Speaker 1: the pandemic, especially finding people who she felt she could
Speaker 1: um explain the stresses that she was under and get
Speaker 1: some help. I mean, I think she also describes that
Speaker 1: she just had way too much unstructured time to kind
Speaker 1: of ruminate in her head, you know, to sort of
Speaker 1: get stuck in these loops of of negative thinking that um, really,
Speaker 1: we're not healthy, we're not helping her or or anybody else.
Speaker 1: And that's unfortunately something that we're hearing from from a
Speaker 1: lot of kids who have been stuck at home during
Speaker 1: the pandemic. You know, we're talking about Melinda and her
Speaker 1: and her struggle here and her mother, Pam. You know,
Speaker 1: obviously this is just one example of it. But this
Speaker 1: emergency reomboarding of psychiatric patients, uh, they say have has
Speaker 1: risen between two hundred and four monthly in Massachusetts during
Speaker 1: the pandemic. So this is just kind of a snapshot
Speaker 1: of what's happening. But this is happening in a lot
Speaker 1: of places to a lot of people. Uh. Following along
Speaker 1: with the story, you know, it wasn't until day seventeen
Speaker 1: that Melinda was in all of this that she was
Speaker 1: finally going to be taken away and placed into another
Speaker 1: program where she would be able to stay for two weeks.
Speaker 1: They adjusted her medication and she started to see a
Speaker 1: little bit of change finally. Yeah, Melinda has been not
Speaker 1: completely stable um since she's been home. UM, but she's
Speaker 1: definitely doing better. I mean, some of her therapy is
Speaker 1: back in person. UM. It's possible that the medication adjustments
Speaker 1: made at the hospital helped. She's had some she's got
Speaker 1: some additional therapy. She's got a therapeutic mentor now, so
Speaker 1: somebody who kind of walks through the world with her
Speaker 1: a little bit, helping her avoid the trigger points that
Speaker 1: that used to kind of send her into these downward spirals.
Speaker 1: So she's got some additional assistance and UM, the family
Speaker 1: is very hopeful that that the that the summer will
Speaker 1: will go well for her. Is the hope that now
Speaker 1: that the pandemic is easing in some cases that this
Speaker 1: would get better in these e R boarding stays, UH,
Speaker 1: the won't won't last as long anymore. In the other
Speaker 1: hospital beds can open up. Is that the hope now
Speaker 1: or is there other stuff being done to to limit
Speaker 1: this kind of thing. Well, I think there's a lot
Speaker 1: of uncertainty about that, because the numbers of kids boarding
Speaker 1: in Massachusetts have not started to drop yet, even though,
Speaker 1: as you said, the pandemic conditions are easing. So it's
Speaker 1: possible that we have a backlog of these mental health
Speaker 1: cases that UM need to be addressed. Honestly, people don't
Speaker 1: really know what to expect in the next few months.
Speaker 1: There are some efforts to try to take care of
Speaker 1: kids more at home, to try to offer some urgent
Speaker 1: care in the community, UM, to open up some psyche
Speaker 1: beds that are not actually in hospitals but in more
Speaker 1: like halfway houses. There are some things underway to try
Speaker 1: to reduce the numbers, but it's still pretty tough in
Speaker 1: Massachusetts and in many states right now. Well, I mean,
Speaker 1: I hope that all these people, all the kids especially,
Speaker 1: can get the help that they need and not have
Speaker 1: to kind of languish there in the e r s
Speaker 1: because it's just not the setting that that they need
Speaker 1: to be in to get the proper help. So hopefully
Speaker 1: we can bring some awareness to all of this and
Speaker 1: and conditions can get better. Martha B. Binger, healthcare reporter
Speaker 1: at w B you are thank you very much for
Speaker 1: joining us. Thank you for having me. I'm Oscar Ramrrors
Speaker 1: and this has been reopening America. Don't forget that. For
Speaker 1: today's big news stories, you can check me out on
Speaker 1: the Daily Dive podcast every Monday Friday. So follow us
Speaker 1: on I Heart Radio or wherever you get your podcast