I-TEAM: CT’s Kids in Crisis, access to mental health care still a problem, parents and advocates say

(WFSB) - “We are in a crisis; we’ve been in a crisis for 15-20 years.”

How do you fix a broken mental health system?

3 years after the start of the pandemic, parents say they still struggle to find enough resources to meet the mental health needs of their kids and teens, with many of their children ending up in emergency rooms.

The state committed millions of dollars to addressing the issue, is that commitment working?

ONE MOTHER’S JOURNEY:

If 5-year-old Keegan’s life was a song, things haven’t always felt in rhythm.

”It started with him destroying classrooms, he had a hard time regulating his emotions, he had very bad impulse control,” says Sarah Arpin, Keegan’s mother. 

Keegan has oppositional defiant disorder and ADHD.

”Basically, they do the opposite of what you say. They have a hard time accepting boundaries,” says Sarah. 

For the last year Sarah Arpin has been fighting to find help for her son.

“Mental health services are very few and far between for him, a child his age, it’s very difficult,” says Sarah.

Sarah and Keegan’s journey started with a call to 211, a free phone service that connects people to resources, followed by a trip to the Backus Hospital Emergency Room last June.

“He had to be restrained and they had to put - they had to give him a shot to calm down,” says Sarah.

There, Sarah says Keegan waited days to be transferred to a psychiatric program in Hartford, because he wasn’t 5 years old yet.

”He was on a psychiatric hold for 3 days until his birthday because they wouldn’t take a child that young, until he turned 5,” says Sarah. “That was the hardest part for me as a mom, to watch my baby go into the care of a hospital.”

During the family’s next trip to Backus ER in December, Sarah says they waited five days before they could get Keegan inpatient care because of the lack of beds.

”It’s really hard to find services. I mean, it’s just - we need to do better,” says Sarah.

ACCESS TO CARE PROBLEM?:

It’s still happening today: kids waiting in emergency rooms, unable to access the care they need.

According to the CT Hospital Association, from January 1, 2023, to April 27, 2023, there were on average 47 child and adolescent patients in hospital emergency departments with 26 of those patients waiting for an acute inpatient psychiatric bed.

At the same time, there were only 8 beds available.

Across the entire state, there are 118 beds, around one bed for every 7700 kids. (Note: this calculation was determined using the most recent Census numbers for children under 18 in CT).

”We’ve seen the rates of depression, anxiety, kids expressing loneliness, hopelessness doing nothing but increasing. We know we had an access to care problem beforehand and it’s all just been amplified over the last several years,” says Doctor Melissa Santos, division head of Pediatric Psychology at CT Children’s in Hartford.

Doctor Santos says children and families tend to end up in the ER asking for help, because navigating the mental health system in the first place can be tricky.

“Does anybody even know how to start? Do you just go on the internet and start searching for something for your child? Do you even know what kind of therapy you’re looking for, what kind of therapist to find?,” says Doctor Santos. 

During the peak of COVID, CT Children’s saw upwards of 50 kids in the ER almost every day.

“We had kids in the emergency room, we had kids on our medical floors, our outpatient clinics where we have psychologists and social workers - all were being flooded with families in need of services,” says Doctor Santos. “But there was no throughput. The continuum of care was completely clogged. So, you had kids in the ED, who needed an inpatient bed, but the inpatient beds were all full and they couldn’t get kids out of the inpatient programs because there were no step-down programs and it was just a complete clogging at every single level.”

The numbers these days are lower, a daily average of 15-26 ER patients at CT Children’s, but still more than what President and CEO Jim Shmerling would like.

“We wouldn’t need as many inpatient beds if we were doing better on the front end. Also on the back end, once a child’s been admitted and we discharge them, they have to have a place to go to continue getting therapy on an outpatient basis,” says Shmerling. “The whole system is broken. At the same time, these families and children deserve much better than what we’re giving them.”

STATE FUNDING:

Last May, the state legislature set aside $300 million for children’s behavioral health services.

The I-Team requested state records related to the funding.

Adding up the numbers, we found more than $135 million has been designated for specific programs so far, while more than $95 million has been spent. (Note: these numbers represent funds given to the Department of Mental Health and Addiction Services and the Department of Children and Families. Additional agency reports were not available at this time).

According to those records, a lot of the money is coming from the American Rescue Plan and will eventually end next year, which puts the future of the programs in question.

“We are going to stay with this because these are our children,” says State Senator Saud Anwar.

State Senator Saud Anwar says initial funding from the bills went to help keep early childcare centers open, as well as expand the 211 system’s capacity.

He says the legislature is working on a solution for long term funding. 

“Our challenge is that we are under some restriction because of the guardrails for our finances that we have put in,” says Senator Anwar.

Connecticut has a large surplus and rainy-day fund but also has fiscal guardrails in place to limit spending.

“And as a result, we cannot put all the money that we can in, we have to balance it out,” says Senator Anwar.

When asked to address concerns that funding is moving too slow, Senator Anwar says, “I’m a critical care doctor, for me everything is moving slow if it’s not happening like yesterday. That’s why I would want this to move faster but I also respect the fact that some of the time for the implementation, we need a large number of people to implement this and there’s so many things. I believe the delays we are already experiencing in the implementation of the intermediate and long-term strategies is because the health care systems are reduced in the workforce, but the state does not have enough workforce either.”

A spokesperson for the Connecticut Office of Policy and Management, who provided the state records mentioned above, added, “As these are a number of new programs, it takes time to stand up new programs and ensure that taxpayer funds are spent properly. The administration is committed to ensuring the allocated funds are dispersed properly and provide assistance to those in need.”

As for Keegan, he’s currently in play therapy which Sarah says is helping.

She’s hoping it will help keep their future in harmony. She says, “I’m trying to be my child’s best advocate and I’m in his corner.”

WHAT RESOURCES ARE THERE?

If you are in search of resources for your child, the state has compiled them all on this website: https://www.connectingtocarect.org/

Four Urgent Crisis Centers are currently being built, with one in Hartford set to open in July. These will be walk-in clinics for those experiencing a mental health crisis, that don’t need to be in the emergency room.

CT Children’s is building a 12-bed med psych inpatient unit. The unit, separate from their ER, will care for children with both medical and psychiatric concerns. This is tentatively scheduled for January 2024.

CONTINUED COVERAGE:

Everyone the I-Team spoke to, says the problem is much larger than just this report.

There are issues with staff shortages, waitlists, Medicaid reimbursements.

The I-Team will continue to cover these topics, speaking with educators, doctors, lawmakers, advocates, parents and kids in the days, weeks and months to come. If you want to reach out to Sam Smink, please do so at sam.smink@wfsb.com.

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