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Connecticut Children’s Hospital plans a new medical psychiatric care unit. Here’s why.

Hartford Courant - 4/27/2022

As the COVID-19 pandemic exacerbated a youth mental health crisis in Connecticut and elsewhere, Connecticut Children’s Hospital filed the paperwork to open a new medical psychiatric unit that could open as soon as next year, officials said.

If the project receives regulatory approval and locks down funding currently allotted in Gov. Ned Lamont’s proposed budget, the new unit will treat children with both physical and psychiatric ailments.

James Shmerling, president and CEO of Connecticut Children’s, said the need for this sort of care predates the pandemic, but the disruption caused by COVID-19 heightened its urgency.

“We’ve always had children staying overnight waiting for an inpatient bed, but COVID exacerbated that,” Shmerling said. “So we went from 20-25 children a day to 35-45 children a day. The problem has always been there, it’s just gotten worse.”

Shmerling said the new unit is meant to reduce the number of children stuck waiting days or weeks in the emergency department due to lack of available psychiatric beds statewide. Currently at Connecticut Children’s a child with both physical and psychiatric needs would be treated for one set of issues and then the other, as opposed to both at the same time.

Children’s mental health has become a growing concern as the COVID-19 pandemic drags on, with emergency room visits for self-harm increasing and surveys finding high levels of depression among children and adolescents. In Connecticut, this has led to calls for action, including legislative proposals to expand resources for youth mental health.

Melissa Santos, head of pediatric psychology at Connecticut Children’s, said the first sign of trouble early in the pandemic was an increase in children showing up with eating disorders. Before long, physicians were seeing not only an increase in self-inflicted injuries but also increases in physical conditions linked directly or indirectly with mental health issues.

“We can see kids that come in with extreme abdominal pain or extreme headaches, and when we dig a little more we begin to realize there are a lot of stressors going on, there’s a lot of anxiety,” Santos said.

The new unit, Santos said, will employ a team of medical and mental health providers, including psychiatrists, psychologists, physical therapists, occupational therapists and more.

“It’s really going to be a multidisciplinary team approach to getting these kids back feeling better both psychically and emotionally,” she said.

In addition, Santos said Connecticut Children’s has worked to improve care for mental health issues in other parts of the hospital, with an emphasis on preventing issues before they develop or fester.

To move forward with the new medical psychiatric unit, Connecticut Children’s will need approval from multiple regulatory agencies, beginning with the Office of Health Strategy, which must approve the hospital’s certificate of need application. Under Lamont’s proposed budget, Connecticut Children’s would receive $10 million to build the new unit, plus $5 million to recruit staff.

If all goes well, Shmerling said, the unit will open in 14-18 months.

Shmerling said the project, while important, represents only “the tip of the iceberg” when it comes to fighting the children’s mental health crisis. Ideally, he said, improved treatment would be coupled with broad interventions to keep kids healthy, including by identifying and targeting those at high risk.

“This is sort of like putting out a major fire,” Schmerling said. “There’s a fire raging, and the inpatient unit will help put out the fire — I’m not sure it will completely eliminate it, but it will help a great deal.”

Alex Putterman can be reached at aputterman@courant.com.

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