Welcome back Chaise Lounge readers! This week’s article delves into the crisis we face as a country in providing mental health services to our most vulnerable citizens, our children. And with the uncertainly about how COVID affects mental health, there may be more to come. This article discusses the increasing need for mental health care, especially in rural areas as the pandemic affects us all in different ways. I invite you all, especially those in North Carolina, to contact your state representatives and senators to let them know that you are concerned about this issue and to make sure they propose or support legislation that will increase access to mental health supports. Of course, Medicaid expansion would be the biggest step toward doing so. For those who live elsewhere, your states are also struggling with this epidemic of mental health needs, so advocacy is necessary across the country.
Throughout the COVID-19 pandemic, the incidence and severity of mental health issues in children are rapidly rising according to a Centers for Disease Control study published in November. The number of mental health-related emergency department visits increased sharply beginning in mid-March 2020 through October with increases of 24% among children aged 5–11 years and 31% among adolescents aged 12–17 years, compared with the same period in 2019.
Anxiety in particular has been amplified by the movement to online learning. For students with learning disabilities, the change means that they no longer have access to the individualized teacher support that could happen within the classroom. For children with autism who crave routine, the upset to their schedules creates emotional chaos. Others are keenly feeling the social isolation from friends and peers.
Many children are facing long waits for psychiatric beds which were already in short supply before the pandemic began. According to Gene Woods, the CEO of Atrium Health, as of December 4, Atrium had 180 patients in their emergency departments across North Carolina waiting for psychiatric evaluation. Many of those patients are children. While this crisis needs immediate attention, perhaps working toward preventing these acute mental health issues, to begin with, is where to begin solving the problem.
Parents can be on the lookout for signs of developing mental health issues before they become an emergency. Getting ahead of a mental health issue before it turns into a crisis is crucial. Within most states, many different agencies are providing a variety of services to support those with mental health issues.
But, navigating the myriad agencies can be overwhelming for most people. Here in North Carolina, we are fortunate to have an agency to supports families in finding help and support for their children. North Carolina Families United (NCFU), a statewide non-profit agency, provides significant support to families of children and youth dealing with mental health issues. NCFU is part of the North Carolina Collaborative for Children, Youth and Families. The agency uses a System of Care model meaning that individuals or family members who have previously used services become service providers themselves called Family Partners. They receive training and certification to become advocates who can directly help families. Because the advocates have the lived experience of having a mental health need themselves or caring for a family member who does, they have a unique understanding of what a family may need.
Services that NCFU Family Partners may provide include:
connecting families with mental health support,
advocating for those in the juvenile justice system,
attending IEP or Child and Family Team meetings for children with special needs,
attending court proceedings
connecting families with in-home physical, speech, or occupational therapy
NCFU identifies people needing their services in innovative ways. Some Family Partners are housed within a pediatrician's office. Others are part of crisis teams located near hospitals so that if a child is in the emergency room for psychiatric reasons, the team can be there right away. But these are the exceptions. In many rural parts of the state, there are no Family Partners or crisis teams. In these counties, children who end up in the emergency room can stay for months before a bed opens up in one of the psychiatric hospitals. And the whole time they are there, they might receive no psychiatric intervention.
Being proactive can help to avoid crises, but the bigger issue is that as a society, we generally do not have solid support for mental health needs. The lack of psychiatric beds in emergency departments is just one symptom of a system that leaves families on their own when they need help the most. Insurance companies reimburse psychologists poorly, so many do not participate in the insurance panels. Even when insurance does cover some part of the therapy, there are still big bills left over. And in North Carolina where there has been no Medicaid expansion, the problems of coverage are exacerbated.
Resources for Parents
If you are concerned that your child is developing mental health issues, please take a look at the resources listed here. Being proactive about getting help can make a difference. While in-person therapy is presently not available, telehealth therapy is.
If you need to find a therapist for a child, you can go to the National Alliance on Mental Illness (NAMI) website and find information for referrals.
The Mayo Clinic offers a guide for parents to consider whether their child’s symptoms warrant medical attention.
HelpGuide also lists symptoms of depression and substance abuse.
North Carolina Resources
The Sandhills Center is offering many free online workshops to anyone interested including how to smooth the transition back to school from online learning to parent support groups to understanding seasonal affective disorder among many other topics.
For statewide resources put together by NCFU, Download the Directory here.
You can call NCFU directly during business hours at 336-395-8828 for non-crisis help.
If you need a referral for services, you can call 211.