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On January 24, an 8-year-old boy from Jamaica Plain was taken to the emergency department at Boston Children’s Hospital. He was in a mental health crisis and had just had a crisis at home.
Karin Broadhurst became the boy’s adoptive mother at the age of 4. She adopted him a few years later. Broadhurst knew he had been abused and neglected before he came into his care. He has post-traumatic stress disorder and sometimes acts in dangerous or aggressive ways, she says.
On the night in question, he took his medication.
“He was on top of my bed and he took my medicine organizer, and he threw it as hard as he could on the floor and it opened,” recalls Broadhurst. “It has a lock, but it’s not very strong. I think it’s meant for the elderly, not kids with mental health issues. So it broke and my meds flew all over the room. … he started trying to grab the pills and threatens to swallow them. And I had to physically hold him back until the police arrived. “
Broadhurst, a single mother, says that due to her son’s history of trauma, he goes into “fight or flight mode.”
“And he feels out of control,” she says. “I don’t think he intended to kill himself. I think he was just … trying to do something that he knew was really wrong and upsetting.
Broadhurst says she sometimes has no choice but to call 911 in order to transport her son safely to the hospital.
When they arrived at Children’s, the doctors wanted to admit the child. But there were no pediatric psychiatric beds available anywhere in Massachusetts. He spent five nights waiting, or “boarding” in the emergency department. Then he was transferred to a regular medical floor in the hospital. As of February 26, he had been boarding at Children’s for 33 days.
“If he [had an inpatient psychiatric bed], he would be in a unit with other children of the same age, ”his mother said. These children would have activities and therapeutic groups throughout the day. The psychiatrist who saw him would make changes to his medication if necessary. He would meet with a clinician and that clinician would do therapeutic work with him, setting goals for him.
“Basically he’s just sitting in a room playing Legos all day, watching TV and playing video games,” she added.
Broadhurst said the daily recording her son receives from a hospital psychiatrist or social worker essentially requires them to ask him a handful of the same questions about whether he feels safe or if he thinks of hurting himself or hurting others.
Dr Patricia Ibeziako, associate chief of clinical services at Boston Children’s Hospital’s Department of Psychiatry, said doctors initiate and change treatments while patients are in boarding school – but the situation is far from ideal.
“What we really want to see is that children can receive the right care in the right setting at the right time. And boarding does not reflect that people are in the right environment for the right care. they need, ”Ibeziako mentioned. “Boarding schools affect children and adolescents with psychiatric illnesses much more than those with illnesses. And the problem has worsened considerably during the pandemic.”
At the end of this week, 40 children were staying at Children’s while awaiting psychiatric beds – 16 of them in emergency room boarding, the rest in medical wards, Ibeziako said.
“This is ridiculous … And we can’t wait six months or a year for some hospitals to build or add rooms. They have to find a solution now.”
Karin Broadhurst
According to the state’s Executive Office of Health and Human Services (EOHHS), since June, boarding schools for psychiatric beds for children and adults have increased by 200% to 400% per month in the same months of l ‘last year.
Once a patient has been embarked for 60 hours, the case is referred to the State Department of Mental Health, which must attempt to locate a bed. For pediatric patients, it takes an average of four days to find one, said an EOHHS spokesperson.
Broadhurst’s son waited four more weeks than that. Earlier this week, they celebrated her ninth birthday in the hospital. She says she wants lawmakers and state officials to prioritize children’s mental health more than they currently do.
“… it’s a crisis, and they can find an emergency way to make extra beds for COVID. And they should be able to find an emergency way to find extra beds for our children. in crisis, ”Broadhurst said. “This is ridiculous … And we can’t wait six months or a year for some hospitals to build or add rooms. They have to find a solution now.”
The State Department of Mental Health said it is working with providers to bring more psychiatric beds online this year. About 200 beds are expected to be created starting in the spring, and the state is offering special incentives for pediatric beds, including increases in reimbursement rates. Boston Children’s Hospital announced the addition of 12 inpatient psychiatric beds at its Waltham facility this fall. It currently has 16 such beds in its Boston hospital and 12 acute care residential beds in Waltham.
Providers say it’s unclear what kind of breach the new beds will cause, as the extent of the boarding problem is unclear.
“There is no real, comprehensive data source on the extent of the boarding problem,” said Amara Azubuike, director of behavioral health policy and advocacy in the government relations department at Boston Children’s Hospital. “We don’t have the total number of children who are in boarding school, where they are being accommodated, what level of care they need and how many beds are actually in use at any one time.”
Legislation has just been filed on Beacon Hill to create an online portal that would track in real time the number of children embarked in which hospitals, their needs and the number of beds available in hospitals across the state, a said Azubuike.
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