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Some kids with mental health conditions living months in Michigan emergency departments

Health care systems in Michigan will soon receive $50 million in state funding for inpatient psychiatric care for children with acute mental illness.

But experts say much more will need to be done to fix huge holes in the mental health care safety net in the state, as hospitals continue to struggle with large numbers of children with serious mental health issues ending up in their emergency departments.

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

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

She says many of these children have developmental disorders like autism, in addition to mental health conditions, and once they're at the ED there's often no place for them to go from there.

That's because most hospitals in the state don't have inpatient pediatric psychiatric units, and there’s a lack of residential treatment options for children. Sending the children home once they are stabilized is often out of the question, too. That’s because home care agencies generally cannot find enough workers to train to help families care for the children.

So the children have to remain at the emergency department.

“Being in an ED for days at a time if not months creates more problems than they came in with,” Appel said. “Every large hospital system in Michigan has a story about a child who has been in their care for weeks, months. And when I say months I mean 200 days, 300 days, because it's so hard to place kids with such complex needs.”

Appel said she hopes to see some of the $50 million in state funding going to the creation of pediatric residential treatment facilities. She said there’s also a need for an intensive-care style of hospitalization for the most severely affected children, with staffing levels of one nurse to one or two patients.

But in addition, Appel says the state’s health care system needs to get children adequate treatment for their mental health needs to prevent them landing in the ED in the first place. That will require more attention to children’s mental health status from schools, primary care doctors, outpatient mental health specialists, and community mental health agencies.

Tracy Samilton covers energy and transportation, including the auto industry and the business response to climate change for Michigan Public. She began her career at Michigan Public as an intern, where she was promptly “bitten by the radio bug,” and never recovered.
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