Children's Hospital Colorado in Colorado Springs experiences volume, acuity overload

Six of the 24 beds in the emergency department at Children’s Hospital Colorado in Colorado Springs are dedicated to mental health patients, but with increasing demand, regular medical beds are sometimes used for mental health cases.

Children’s Hospital Colorado officials have declared “a pediatric mental health state of emergency,” saying their entire system is taxed and experiencing an unprecedented overload of children as young as 8 needing immediate treatment, largely for suicidal thoughts and attempts.

“We’re overrun with kids attempting suicide and suffering from other forms of major mental health illness,” Jena Hausmann, president and CEO of Children’s Hospital Colorado, said May 25 in a virtual roundtable discussion. “There are so many organizations equally overwhelmed; the sheer magnitude of this situation warrants a different level of support.”

Hausmann issued a “call to action” to Gov. Jared Polis, state lawmakers and agencies to prioritize children’s mental health services, release more funding for suicide prevention and resiliency-building programs, recruit more providers, increase flexibility in the system and reduce bureaucracy in enabling children to access services.

On any given day, between one dozen and two dozen children systemwide may wait hours or days to get a behavioral health bed, said Dr. David Brumbaugh, chief medical officer for Children’s Hospital Colorado.

With the bed shortage, Hausman is advocating for communities to receive the support to set up emergency centers, much like the shelters that emerged for COVID-19 patients, to accommodate the overflow of children who need to be admitted for mental health treatment.

She called on the governor to use executive orders and public health orders to do so.

“It’s been devastating to see suicide become the leading cause of death for Colorado’s children,” Hausmann said, adding that if things don’t change, more children will be lost to suicide.

Pandemic-related problems have intensified for Colorado children since January, statistics show.

Children’s Hospital Colorado, which operates 16 urgent, emergency and specialty locations, saw a 72% increase systemwide in behavioral health emergency department visits from January through April over the same period in 2019, officials said.

In April alone, the prevalence of acute cases jumped 90%, compared with April of 2019, Brumbaugh said.

“That’s almost a doubling for acute behavior health services,” he said, “and the No. 1 reason is suicide attempt, which is extraordinary.”

The primary concern is that children will develop chronic mental health afflictions, which will impact their opportunities in life, said Dr. Jenna Glover, director of psychology training at the Anschutz Medical Campus in Aurora.

“It’s not going to go away next year,” she said.

Children are coping with pandemic stress primarily through substance use, withdrawal from normal involvement and eating-disorder behavior, she said.

“Kids are using those in a way to escape feelings or trying to gain a sense of control — as a result of anxiety and depression not being treated,” Glover said.

The severity is happening as society comes out of the pandemic because children are expected to return to the way their lives were without the tools to adapt, she said.

“Kids have dealt with chronic stress for the past year that interrupted their development in education, their social development, and many feel behind and completely unprepared for going back to regular functioning,” Glover said. “Now they just have to reengage in life, and they don’t have the resources. They’re burned out. They’re hopeless.”

Hopelessness is the No. 1 indicator of youth suicides and attempts, she added.

Suicide of youths ages 11-17 in El Paso County jumped from nine deaths in 2019 to 15 in 2020, according to a report the county coroner’s office released last month.

Pikes Peak Suicide Prevention in Colorado Springs has seen a steady increase since the pandemic’s onset of youths in both group and individual therapy, said Executive Director Cass Walton.

The past three months has brought “a surge,” she said, along with more inquires from parents needing help navigating the system, seeking advice on an effective discharge plan from an in-patient stay and creating a safe home environment.

The organization has been handing out safes, gun locks and after-discharge care packages for teens, Walton said, and has added more group sessions to accommodate the need.

Common threads that are emerging include youth struggling with age-related social issues, having a lack of strong social connections and dealing with parental rejection over gender and sexuality preferences.

Youths also are identifying the increasing prevalence of suicide among TikTok and Instagram influencers and suicidal ideation in music as stressors.

“Our youth have access to so much content,” she said. “A few months back, several of our program participants were struck when the link for the man who died by suicide on Facebook live was floating around, and parents are starting to cue in and realize that their child needs help — which is good.”

More parents want to take suicide prevention training and attend support groups, Walton said, a change from two years ago when the organization canceled programs due to low attendance.

“Our community is responding to this complex issue,” Walton said, “but it is going to take time and resources to really get a handle on it.”

There is an urgency, though, roundtable participants said. Children’s Hospital Colorado’s emergency air transport team is hauling three to four teens who attempt suicide per week and has requested additional training, officials said.

“We’re completely tapped, our beds are full, the supply has not met the demand,” Brumbaugh said.

Children’s Hospital is expanding several campuses to add inpatient and outpatient mental health beds and services, including in Colorado Springs.

“Our kids have run out of resilience, their tank is empty and it’s impacting families across our state,” Brumbaugh said. “As a result, we’re seeing kids who were largely functional, the floor has fallen out from them. It’s a tough time.”

Between $400 and $550 million of Colorado’s $3.8 billion cut of the federal American Rescue Plan will be spent on mental and behavioral health programs, according to a proposal the governor released Monday. It is unclear how much would go toward pediatric programs.

In April, Polis signed a bill that establishes a new state Behavioral Health Administration to align, coordinate and integrate state mental health and substance use programs and funding under one government entity. It carries a budget allocation of $9 million for the coming fiscal year.

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