Suicide crisis, mental exhaustion: Children struggle with re-admission

After two suicidal crises during pandemic isolation, 16-year-old Zach Sampson feels strong but worries his social skills have gone stale.

Amara Bhatia has overcome her epidural depression, but the teen feels exhausted in a state of “neutrality”. Virginia Ship is making adjustments, but says returning to normal is “kind of unusual for me.”

After months of social distancing, online schooling and other restrictions, many children are feeling the effects of the pandemic or facing new challenges.

An increase in teen suicide attempts and other mental health crises prompted Children’s Hospital Colorado to declare a state of emergency in late May, when emergency departments and hospital inpatient beds were filled with suicidal children and other mental problems . Jason Williams, a pediatric psychologist at the hospital in Aurora, said waiting times for psychiatric treatment at the specialized emergency-department doubled in May to about 20 hours.

Other children’s hospitals are facing similar challenges.

In normal times, the activities that come as the school year ends—finals, prom, graduation, summer job hunts—can be stressful for even the most resilient kids. But after more than a year of dealing with pandemic restrictions, many have worsened and “there isn’t enough in the tank of resilience” to handle stress that would have been manageable earlier, Williams said.

“When the pandemic first hit, we saw an increase in severe cases in crisis assessment,” said children struggling with “locking down their whole worlds,” said Christine Certain, a mental health counselor who works with Arnold Palmer of Orlando Health. Works for the hospital. children. ”Now, as we see the world reopening, … it’s asking these kids to make a big difference again.

In some children’s hospitals, psychiatric cases have been high throughout the pandemic; Others have recently seen another surge.

Hospital psychologist Terry Andrews said at Wolfson Children’s Hospital in Jacksonville, Florida, behavioral unit admissions for children 13 and younger have been increasing by 2020 and on pace to reach 230 this year, up from 2019. four times higher than that. . For older teens, admissions were five times higher than last year and remained as high as the previous month.

At Dayton Children’s Hospital in Ohio, mental health unit visits increased 30% from July 2020 to May, totaling nearly 1,300. The hospital’s vice president, Dr. John Dubey, said the hospital doubled the number of available beds to 24 and lowered the minimum age for treatment from 12 years to 9 years.

“The enormous demand for pediatric mental health services is placing an unprecedented pressure on pediatric facilities, primary care, schools and community-based organizations that support children’s well-being,” said Amy Knight, president of the Children’s Hospital Association.

Alison Tothy, medical director of the pediatric emergency department at the University of Chicago’s Comer Children’s Hospital, said her ER has seen children in distress over the past year, suicidal thoughts, biting and other self-harm behaviors, battling depression and aggression. are. explosion. The children have been stabilized and referred elsewhere for treatment.

“Families are coming to us because we are, in some cases, a last resort. Outpatient resources are scarce,” and parents say they can’t get an appointment for two months, she said.

In Florida, the wait for outpatient treatment is even longer and many physicians do not accept children insured through Medicaid, Andrews said.

At Children’s Hospital Colorado, emergency department visits for behavioral health problems were 90% higher in April 2021 than in April 2019 and remained high in May. Although the pace slowed in June, hospital officials are concerned about another spike when school resumes.

Williams said the issues the hospital is treating range “across the board” from children with past mental health issues that have worsened to those who have never struggled before the pandemic.

Like many states, Colorado does not have enough child and adolescent mental health practitioners to meet demand, an issue even before the pandemic, Williams said.

For children who require outpatient treatment, it takes six to nine months for an appointment. And many physicians do not accept health insurance, leaving struggling families with few options. Delaying treatment can lead to distress that drives children to the ER.

Williams said patients who improve after psychiatric care but are not well enough to go home are being sent out of state, because Colorado doesn’t have enough facilities.

Sampson says “just a lot of stuff” caused his first crisis last August. The Jacksonville, Florida, teen struggled with online learning and spent hours alone in her room playing video games and scrolling the Internet, drawn to “dark sites that hurt my brain.”

He told his suicidal thoughts to a friend, who called the police. He spent a week in the hospital under psychiatric care.

Both his parents worked in mental health jobs, but they had no idea how he was struggling.

“We had realized that he was spending more time in isolation, not really taking a shower and that sort of stuff, but we were in the middle of a pandemic. Nobody was really doing those things,'” his mother, Jennifer Sampson, said.

The teen began virtual psychotherapy but in March her self-destructive thoughts resurfaced. Hospital psychiatric beds were full so he waited in a holding area for a week to receive treatment, his mother recalled.

Now on mood stabilizers, he’s been making constant doctor visits, has finished sophomore years and looks forward to returning to school in person this fall. Still, he says it’s hard to motivate yourself to leave the house to go to the gym or hang out with friends.

“I definitely find that my social skills are rusting,” Sampson said.

“I think it’s going to be something we’ve been dealing with for quite some time,” her mother said.

This is true even for those who have not reached the point of crisis.

Bhatia, a 17-year-old self-described “conservative introvert” with clinical anxiety, also worries about returning to class for senior year.

The Oakland, Calif., teen says the pandemic almost began as a welcome change. It takes effort to be social, and the isolation allowed him to recharge. Still, she suffered from depression, became disillusioned with virtual school and missed her friends.

She used to be a hugger but has become “a bit more of a germaphobe” and says that since social distancing restrictions were lifted several times she was hugged, she froze.

The pandemic has exhausted him, “like running a marathon, and I’m finally getting to the end and I’m just so tired at this point.”

“I feel like I don’t have the energy for happiness,” she said.

For 18-year-old Shipp from Oakland, the pandemic came in her senior year as she was planning a trip to Europe and looking forward to college in the fall. This did not happen and she described 2020 as the year of negative thinking, stuck in her room alone with her thoughts.

“I was feeling sad and anxious and very scared for the future,” she said.

As a black woman, she wanted to join a march protesting the killing of George Floyd, but decided that close contact with strangers was too risky.

She doesn’t know anyone who got very sick or died, but says she worries about COVID-19 “every single day.” Shipp used meditation to help relieve stress.

She recently got vaccinated and learned college at Cal Poly in Pomona will be in person in the fall. But she’s not sure she’s completely ready.

“It’s still a little weird because now, all of a sudden… you don’t have to wear a mask? It’s like jumping into the water too fast,” Shipp said. “The normalcy is kind of unusual for me.”


Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.


The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. AP is solely responsible for all content.


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