BLOG: TelePsychiatry is Today’s Solution to the National Emergency in Children’s Mental Health

By Chris Gallagher, MD, CEO, Access TeleCare

The COVID-19 pandemic created not just a global public health crisis but a behavioral health crisis as well, particularly for children and adolescents. Exponential growth in the need for behavioral health care has collided with the longstanding shortage of behavioral health care providers and resources to create a national emergency.

Resolving this emergency will take time, planning, and a significant investment of resources to train more behavioral health professionals, create additional inpatient and step-down psychiatric capacity, and address the geographic disparities in access to care. This is time that many children and adolescents don’t have.

But, there is hope. Telepsychiatry for hospitals’ emergency departments and inpatient units has proven itself to be invaluable in bringing psychiatric expertise to patients in need, and it can be implemented today.

The Desperate Need for Behavioral Health Care

“[Emergency department] boarding has become its own public health emergency,” wrote the authors of an unprecedented letter to the White House in early November. The letter, led by the American College of Emergency Physicians, with an additional 34 health care organizations signing on, is a plea for help for overcrowded emergency departments because patients are waiting for admission for an inpatient bed in the hospital, for transfer to psychiatric, skilled nursing, or other specialized facilities, or waiting to return to a nursing home.

The problem for children needing psychiatric attention is particularly acute. The letter states that, “those in mental health crises, often children or adolescents, board for months in chaotic EDs while waiting for a psychiatric inpatient bed to open anywhere.”

The mental health crisis for children and adolescents has never been more dire.

Children’s hospitals saw a 45 percent increase in pediatric self-injury and suicide cases between January and July 2021. In 2020, pediatric mental health-related hospital emergency department visits increased 24 percent for children ages 5-11 and 31 percent for older children and adolescents. In October 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association declared a national emergency in children’s mental health. 

Of the country’s nearly 330 million residents, more than 150 million live in a federally designated mental health professional shortage area. More than half of U.S. counties have no psychiatrists, and the shortage is only expected to worsen in coming years, with an expected shortage of between 14,280 and 31,109 psychiatrists by 2024. 

TelePsychiatry is Today’s Solution

Inpatient and emergency telePsychiatry is a solution that can and is being applied today in hospitals of all sizes across the country to diagnose, stabilize, and begin treatment for children and adolescents experiencing a behavioral health crisis. Every hospital can have fast access to highly trained, expert behavioral health professionals via the power of telemedicine. Physical presence and geography are no longer barriers to care. 

The keys are reliable technology, partnership with in-person staff, and world-class psychiatric professionals. When these three elements work together, children and adolescents can be helped with compassion and expertise.

My colleague, Dr. John Kenny, a board-certified psychiatrist shared a story of one child helped by the availability of telepsychiatry:

A 10-year-old boy had been in and out of his local hospital emergency room multiple times in the past year. He kept having intrusive urges to harm his younger brother. The first time he went to the ED, he was diagnosed with depression, started on medication, and discharged. His parents brought him back a second time because the urges hadn’t resolved. A different emergency provider diagnosed him with psychosis and prescribed treatment accordingly, but the child’s condition didn’t change. The third time the child came to the ED, the hospital had begun working with our telePsychiatrists, and the emergency department team arranged a consultation with one of our board-certified telepsychiatrists. Working with the child, his family, and the in-person clinicians, the telepsychiatrist correctly diagnosed the child with OCD and set the child on a course for correct treatment.”

We have an obligation to help the children and adolescents who have suffered as a result of the pandemic. We can do that by investing in proven solutions that can be implemented today. TelePsychiatry is at the top of that list.

Learn more about specialty telemedicine by visiting the Access TeleCare Team at ATA2023, Booth #414.

Chris Gallagher, MD, is a board-certified cardiologist and serves as Chief Executive Officer of Access TeleCare, the largest national provider of acute care telemedicine.