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More Adolescents Seek Medical Care For Mental Health Issues

Phillip Reese - California Healthline - November 11, 2019  

Less than a decade ago, the emergency department at Rady Children’s Hospital in San Diego would see maybe one or two young psychiatric patients per day, said Dr. Benjamin Maxwell, the hospital’s interim director of child and adolescent psychiatry. Now, it’s not unusual for the emergency room to see 10 psychiatric patients in a day, and sometimes even 20, said Maxwell. “What a lot of times is happening now is kids aren’t getting the care they need until it gets to the point where it is dangerous,” he said.

ERs throughout California are reporting a sharp increase in adolescents and young adults seeking care for a mental health crisis. In 2018, California ERs treated 84,584 young patients ages 13 to 21 who had a primary diagnosis involving mental health. That is up from 59,705 in 2012, a 42% increase, according to data provided by the Office of Statewide Health Planning and Development. By comparison, the number of ER encounters among that age group for all other diagnoses grew by just 4% over the same period. And the number of ER encounters involving mental health among all other age groups — everyone except adolescents and young adults — rose by about 18%.

Increase in Youth Mental Health ER VisitsThe spike in youth mental health visits corresponds with a recent survey that found that members of “Generation Z” — defined in the survey as people born since 1997 — are more likely than other generations to report their mental health as fair or poor. The 2018 polling, done on behalf of the American Psychological Association, also found that members of Generation Z, along with millennials, are more likely to report receiving treatment for mental health issues.

The trend corresponds with another alarming development, as well: a marked increase in suicides among teens and young adults. About 7.5 of every 100,000 young people ages 13 to 21 in California died by suicide in 2017, up from a rate of 4.9 per 100,000 in 2008, according to the latest figures from the U.S. Centers for Disease Control and Prevention. Nationwide, suicides in that age range rose from 7.2 to 11.3 per 100,000 from 2008 to 2017.

Researchers are studying the causes of the surging reports of mental distress among America’s young people. Many recent theories note that the trend parallels the rise of social media, an ever-present window on peer activities that can exacerbate adolescent insecurities and open new avenues of bullying. “Even though this generation has been raised with social media, youth are feeling more disconnected, judged, bullied and pressured from their peers,” said Susan Coats, a school psychologist at Baldwin Park Unified School District near Los Angeles.

“Social media: It’s a blessing and it’s a curse,” Coats added. “Social media has brought youth together in a forum where maybe they may have felt isolated before, but it also has undermined interpersonal relationships.” Members of Generation Z also report significant levels of stress about personal debt, housing instability and hunger, as well as mass shootings and climate change, according to the American Psychological Association survey.

Resources to prevent a mental health crisis among youth are often lacking. (Editor's Note: Aurora Charter Oak Hospital provides inpatient treatment for adolescents ages 13-17 experiencing a mental health crisis.)

“We’re not doing a great job with … catching things before they devolve into broader problems, and we’re not doing a good job with prevention,” said Lishaun Francis, associate director of health collaborations at Children Now, an Oakland-based nonprofit.

Many California school districts don’t have enough school psychologists and don’t devote enough resources to teaching students how to cope with depression, anxiety and other mental health issues said Coats, who chairs the mental health and crisis consultation committee of the California Association of School Psychologists. In the broader community, medical providers also are struggling to keep up. “Many times there aren’t psychiatric beds available for kids in our community,” Maxwell said.

Most of the adolescents who come into the emergency room at Rady Children’s Hospital during a mental health crisis are considering suicide, have attempted suicide or have harmed themselves, said Maxwell, who is also the hospital’s medical director of inpatient psychiatry. These patients are triaged and quickly seen by a social worker. Often, a behavioral health assistant is assigned to sit with the patients throughout their stay. “Suicidal patients — we don’t want them to be alone at all in a busy emergency department,” Maxwell said. “So that’s a major staffing increase.” 

Rady Children’s Hospital plans to open a six-bed, 24-hour psychiatric emergency department in the spring. Improving emergency care will help, Maxwell said, but a better solution would be to intervene with young people before they need an ER. “The ED surge probably represents a failure of the system at large,” Maxwell said. “They’re ending up in the emergency department because they’re not getting the care they need when they need it.”

Phillip Reese is a data reporting specialist and an assistant professor of journalism at California State University-Sacramento.


Our Newest Employee of the Month: Emmett H. 

California Launches Peer-Run Mental Health 'Warm' Line 

The Mental Health Association of San Francisco has been running a Bay Area warm line since 2014, but outreach manager Peter Murphy says they lost their state funding in 2018 and have had to rely on volunteers to stay open. Now, they’re using $10.8 million from Gov. Gavin Newsom’s first budget to expand the line statewide and operate it for the next three years. The California Peer-Run Warm Line launches in advance of World Mental Health Day on Thursday. “Especially for isolated areas, rural areas, it can be a great service to provide support for people who may not have very good access to mental health services,” Murphy said. The line will be staffed 24/7 by people who have lived experience with mental illness. The center expects to receive 25,000 calls per year. 

Reach the California Peer-Run Warm Line at 1-855-845-7415.

The National Suicide Prevention Lifeline can be reached at 1-800-273-8255.

Editor's Note: Aurora Charter Oak Hospital's Assessment Center is open 24 hours a day: 800-654-2673.   

 


How Many Homeless in L.A. are Affected by Mental Illness or Substance Abuse?


The Rise of Meth Use in the United States

09/20/2019  SAMSHSA

The number of fatal overdoses involving meth has more than tripled (PDF | 336 KB) between 2011 and 2016, according to the CDC. Use is also on the rise between 2016-2018 for most age groups. In 2018, more than 106,000 adults aged 26 or older used meth—a 43 percent increase over the previous year.

Short-term Effects of Meth

Even taking small amounts of meth, or just trying it once, can cause harmful health effects, including:

  • Increased blood pressure and body temperature
  • Faster breathing
  • Rapid or irregular heartbeat
  • Loss of appetite, disturbed sleep patterns, or nausea
  • Bizarre, erratic, aggressive, irritable, or violent behavior

 

Long-term Health Risks of Meth

Chronic meth use leads to many damaging, long-term health effects, even when users stop taking meth, including:

  • Permanent damage to the heart and brain
  • High blood pressure leading to heart attacks, strokes, and death
  • Liver, kidney, and lung damage
  • Anxiety, confusion, or insomnia
  • Paranoia, hallucinations, mood disturbances, delusions, or violent behavior (psychotic symptoms can sometimes last for months or years after quitting meth)
  • Intense itching, causing skin sores from scratching
  • Severe dental problems (“meth mouth”)

Need Help?

With the right treatment plan, recovery is possible. If you, or someone you know, needs help with a substance use disorder, including meth use, call SAMHSA’s National Helpline at 1-800-662-HELP (4357) or TTY: 1-800-487-4889, or use SAMHSA’s Behavioral Health Treatment Services Locator to get help.


New SAMSHA Video on Suicide Prevention - Sept. 13, 2019

New SAMSHA Video on Suicide Prevention - Sept. 13, 2019

It can make you feel alone or guilty when you’re not. But it can be stopped. See the lies suicide may be telling you and your loved ones, and what you can do to prevent suicide.

To learn more about preventing suicide, visit samhsa.gov/suicide  or call the National Suicide Prevention Lifeline at 1-800-273-TALK for 24/7 free and confidential support. 


LA County Mental Health Evaluation Teams Expand - Sept. 9, 2019

A team of LA County sheriff deputies and social workers from the Department of Mental Health is credited with dropping the number of uses of force involving law enforcement and those with mental health illnesses in Los Angeles County. Watch this KNBC News video report from Monday, Sept. 9, 2019.  Aurora Charter Oak supports the expansion of these teams which, depending on the individual’s condition, can transport directly to a mental health urgent care center or another treatment facility.

KNBC Report - LA County MET Expands