California Children Often Face Waits for Mental Health Care
California children seeking mental health care following crises often face days-long waits in emergency departments before being sent to a mental health care facility up to hundreds of miles away, the Modesto Bee reports.
According to the Bee, EDs have become "way stations" for children who need psychiatric care.
Those who are placed on involuntary holds because they present danger to themselves or others are sent to psychiatric hospitals and later released with referrals for outpatient services after they have been stabilized. However, EDs serve as a first stop for such individuals because they need medical screenings and an evaluation of their mental health.
Stanislaus County Children Face Delays in Care
Stanislaus County is one area of the state that has faced issues with delays in care for children who need mental health care.
Madelyn Schlaepfer, director of mental health in the county, said that most children who face delays are between ages 12 and 17. They can wait days for an open bed in an out-of-county facility in areas such as:
- The Bay Area;
- Sacramento; and
- Southern California.
Schlaepfer said children can suffer trauma caused by the delays in care and long ambulance rides to treatment centers. In addition, Schlaepfer -- in a report to the county Board of Supervisors -- said children can be placed in EDs with adults exhibiting psychotic symptoms, which can worsen children's mental health.
She said, "Children and youth become increasingly distressed beyond the state in which they were brought into the [ED]."
Efforts To Improve Conditions
According to Schlaepfer, the county plans to use crisis intervention as a way to reduce hospitalizations for children -- a service it has already started offering to adults.
The county is developing a plan with Doctors Medical Center for a crisis intervention unit. At the facility, children would be assessed and given medication to stabilize their conditions. In addition, parents would receive education for helping to prevent mental health crises.
County supervisors likely will consider the proposal later this month, and services could start next year, the Bee reports.
Narrow Network Concerns
Stanislaus County officials have said that such services would largely benefit uninsured families and those with Medi-Cal coverage, because the county is required to treat such populations. Medi-Cal is California's Medicaid program.
However, families with private insurance often seek providers from narrow networks. For example, San Joaquin Valley, which has a high rate of individuals with mental health issues, has eight psychiatrists per 100,000 residents -- the lowest rate in California -- the Bee reports.
However, the Valley Consortium for Medical Education has proposed a four-year program to help train psychiatrists in Stanislaus County. The program would use four veteran psychiatrists to train 12 to 16 residents, who would work in the ED, eventually rotate to clinics and potentially stay to practice in the community (Carlson, Modesto Bee, 10/4).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.