An ABC11 I-Team Investigation dug into the data of pediatric Emergency Room visits for a mental or behavioral health issue at the Research Triangle's three major hospital systems: UNC Health, Duke Health, and WakeMed. The trends are remarkably consistent; the actual number of visits is steady compared to the months before the pandemic, but the length of those visits, the severity of the cases and the rate of hospitalizations are all metrics showing a significant surge.
"Some folks are here on their own volition and they want to get help. Some folks are here because someone else recognized a problem," Dr. Angela Strain, Chief of Emergency Psychiatry at UNC Hospital in Chapel Hill, explained to ABC11. "We always try if someone is able to return home and be safe, we try to figure that out, but over this past year it's been less frequent we've been able to do that."
Strain, a mother of young children herself, said her patients range in ages from 5 to 17.
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"The kids will say they're sad. They'll say that they're worried," Strain said. "A 5-year-old is not going to describe his feelings the same way as an adult, but they have their own way to communicate, and they communicate through their behavior. They're acting out, aggressive, with the younger kids. As they get older they describe emotions a bit better. Teenagers will come in with anxiety and depression and suicidal thinking."
Indeed, space at each hospital is already at a premium -- as is time with a physician.
LONGER HOSPITAL STAYS
"The length of stay has gone up by 40% compared to previous years," Dr. Brian Kincaid, medical director, Psychiatric Emergency Department Services at Duke University Hospital, told ABC11. "This seems to speak to problems with severity and capacity, suggesting that when crises happen, they are either more severe or placement is more challenging (or both). During the pandemic, psychiatric beds have been less available due to facilities decreasing capacity for infection control, or temporarily closing because of quarantines."
At WakeMed, providers describe both an influx of patients with existing conditions such as ADHD or autism, and some children who never sought treatment of interventions before.
"If you think of the tenants of suicidality, it's worthlessness, hopelessness, and much like adults, kids are feeling untethered," Dr. Jessica Tomasula, Pediatric Psychologist and Manager of Outpatient Behavioral Health Department at WakeMed, told the I-Team. "We see a lot of kids feeling worthless because they're gaining significant amounts of weight which is understandable if you're stuck in the house doing virtual learning and their parents are stuck in the house doing the same thing."
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All providers, meanwhile, are simultaneously trying to reach children where they are -- virtually -- and prevent more urgent interventions.
"We knew patients and families were struggling to take time off from work to make it to those appointments," Tomasula added. "We knew they were concerned about stigma and confidentiality. We're still able to do that care but with greater access and more frequent visits. That has been helpful."
CHALLENGES OF RETURNING TO SCHOOLS
Physicians at each health care system also agreed that going back to school will present challenges and will not be an immediate remedy.
"They are definitely a lot of secondary effects of the pandemic," Strain said. "People losing jobs, homes and their lives are disrupted."
Tomasula added: "If anything, people realize now is the time to recognize the importance of treating these conditions."
To help with the stressful transition of going back, there may be a simple solution that is perfect for this time of year.
"Getting sunlight, fresh air, physical activity," Strain said. "Be a kid, absolutely."