About five years ago, pediatricians at Vanderbilt University Medical Center in Nashville found that more and more of their inpatient beds at the children’s hospital were occupied by children and adolescents with mental health issues, especially those who had come in because of suicide attempts, or suicidal thoughts. These patients were known as “boarders”: They were waiting for psychiatric placement because it wasn’t safe for them to go home.
The doctors wondered whether the problem was specific to their city, perhaps reflecting scarce local resources. But in a new study in the journal Pediatrics, they found that this same pattern held true around the country over the period from 2008 to 2015.
“What we find nationwide is that over the last decade, the numbers of kids being admitted or seeking help in the emergency department or hospital for suicidal ideation or attempts have dramatically increased,” said Dr. Gregory Plemmons, an associate professor of pediatrics at the Monroe Carell Jr. Children’s Hospital at Vanderbilt and the first author on the study. In fact, over the study period, the proportion of emergency room and hospital encounters for these suicide-related diagnoses almost tripled, from 0.66 percent in 2008 to 1.82 percent in 2015. And the rate of increase was highest among adolescent girls.
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It is also widely understood in the pediatrics community that there are not enough mental health workers available to our patients, not enough outpatient therapists and not enough inpatient beds. “We’re lobbying every day for more facilities, more beds, more mental health providers,” Dr. Plemmons said. Many adolescents with depression do not look for help, and many don’t have access to mental health specialists; the American Academy of Pediatrics published guidelines earlier this year for primary care pediatricians dealing with adolescent depression, and recommended screening all children 12 and up.
