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MIAMI (CBSMiami) – Parents of children struggling with depression, anxiety, stress, unexplained outbursts and behavioral issues could face frustration while trying to book them an appointment with a mental health professional.
If not an emergency, it could take anywhere from one to four months for a child to see a counselor, therapist or social worker, depending on what type of care they need.
Dr. Carla Allan, the division director of psychology at Phoenix Children’s Hospital, encourages parents to take preventative steps and not hesitate to make an appointment.
Unfortunately, over the pandemic, she has seen more school-age kids show up to the emergency department because they’re at-risk of hurting themselves. Some kids may have a hard time dealing with rapid changes in school, schedules, and COVID guidelines.
“I think parents and families need to know that right away. Your ability to pick up the phone and call and be seen is probably not that great unless you’re in immediate danger… in that case you should bring your children to the local emergency room or mental health hospital,” she said.
Part of the problem for the long wait is the nationwide shortage of mental health professionals and an increase in demand. Industry insiders blame the shortage on a combination of low pay and high burnout and turnover from high caseloads.
The American Academy of Pediatrics declared a national emergency in child and adolescent health in October 2021.
“I think that’s normal whether you’re being seen in the community, whether you’re being seen at a hospital. No matter where, because we have a mental health care workforce shortage that was bad before the pandemic,” she explained.
So what can parents do to maintain their child’s mental health while they wait for that appointment? What can they do to help their child before it escalates to a trip to the emergency room because they’re thinking of hurting themselves or others?
Dr. Allan said now is really the time to check in with kids as they physically return to the classroom from a relaxing winter break.
“Sometimes when they return to school and those stressors come back, it’s really important we develop routines to check in more regularly during that time,” she explained.
But what is the age-appropriate way to “check in” and how? Dr. Allan said it’s simple.
“So at dinner, whenever there’s an opportunity, ask how are you doing? And with kids check ins really look more like play, special time,” she explained. “With teenagers, it’s more just asking repeatedly and often and being persistent and not taking that first sign of resistance as a sign that you shouldn’t be asking. Kids need to know that you’re predictably, reliably there for them.”
She also emphasized the need for parents to explain and demonstrate a healthy way to deal with their own mental health struggles.
“As adults, I think we need to be talking about our own feelings and modeling self-awareness and coping strategies,” she said. “If they (children) never see what’s behind the curtain and how we’re problem-solving our way through the challenges, they can’t learn it as easily for themselves.”
She provided this script for example:
“Mom is feeling hard about work these days. It feels stressful. I’m worried that I’m not enough. That I’m not able to do it all. And I want you to know that’s a normal feeling lots of people have. I have it and here’s how I deal with that. I deal with it by spending time with you. By distracting myself with engaging activities, by taking walks, those things are really important and those are strategies you can do too. Do you ever feel that way?”
Dr. Allan also advised locking up firearms and ammunition separately. And removing any knives, prescription medication, objects that could be used to harm themselves. “When they’re in a crisis, their emotions move faster than their brains do,” she explained. Phoenix Children’s Hospital has been working on solutions to help solve the mental health professional shortage.
In the last two years, Dr. Jared Muenzer, PCH’s physician-in-chief, said the hospital has hired more staff, including five psychiatric nurse practitioners. They’re included in a team of about 50 mental health professionals, including Licensed Clinical Social Workers, mental health therapists, psychiatrists, psychologists. However, Dr. Muenzer stressed that the hospital is not going to be able to “hire our way out” of the problem.
Last April, he said 40 children were in Emergency Department holding beds, waiting for a referral and the hospital system was struggling to manage the waiting list. In football terms, he said PCH is working to be the “quarterback of care” and that it’s going to take an “all hands on deck” approach.
He said part of the solution will be to expand partnerships with parents, schools, the community, pediatricians to help maintain mental health and recognize and help kids cope with issues before it escalates.
High-risk kids who do make it to PCH’s emergency department, some as young as 6 years old, are able to meet with a behavioral health provider as often as necessary to treat and stabilize patients and act as a “bridge” until long-term care can be arranged.
So far, the hospital has partnered with Arizona State University to help teach the next generation of social workers and is currently working on a waiting list intervention program set to launch sometime this year.