DENVER – The number of children presenting to emergency departments in Colorado has more than doubled in the past five years, from 2,002 in 2016 to 5,168 in 2021.
A similar one the number of children went to emergency departments between 2021 and 2022, meaning that while the number was leveling off, it started to level off at a very elevated level of need.
The state has a lack of resources, a lack of beds and very often, families do not know where to turn in a moment of crisis.
However, a look at history shows that we have made the same mistakes over and over when it comes to treating mental health.
The current situation
In the more than four years since Kari Eckert has bravely shared her family’s story, one thing has remained the same – suicide is still one of the leading causes of death for teenagers.
“We can change that,” Eckert said.
Her son, Robbie, died in October 2018 by suicide.
“I was an engaged mother, Robbie was a sophomore in high school. We didn’t know Robbie was suffering,” she said.
Since then she has worked to raise awareness and work with teenagers through the foundation her family started Rob’s hope.
“Robbie was a great kid, very well-liked, empathetic and kind like me,” Kari said. “Robbie didn’t know he was important on his own, and enough. I know Robbie was enough. I want kids who can be able to relate to how Robbie felt, that they are enough.”
On Wednesday, she was at the Colorado State Capitol meeting with lawmakers and urging them to take action as resources for children dwindle and more families seek help.
“A lot of it depends on funding, we can’t use that as an excuse anymore,” she said.
How did we get here?
Vincent Atchity is the executive director for Mental Health Colorado.
The turning point that stands to him dates back decades.
“Deinstitutionalization started in the 1960s,” he said. “The Kennedy family understood how important mental health is and to properly meet the needs of people with mental health needs.”
This is when the country began to move away from mental institutions for good reasons. There were few standards for health care. People were hidden, restrained and even experimented.
“Part of that movement led to the creation of community mental health centers,” Atchity said.
He said this was the right decision for better care, but it never materialized properly, with insufficient access and resources, while beds were disappearing.
And so, Atchity said, many people were institutionalized in another way — arrested and in jail.
There were similar problems, according to Atchity, including staff shortages in the 1950s and a nurses’ strike in the 70s because they were so burned out and underpaid.
As the population grew, the problem became stronger.
In 2018, we saw a familiar situation emerge again.
“The Family First Prevention Services Act was passed in 2018 on a federal level,” said Zach Zaslow with Children’s Hospital Colorado. “We supported that bill.”
It aims to get children out of institutional settings and back into their homes and communities.
“In Colorado, we did the first part of that deal,” Zaslow said. “We haven’t built those supports and services yet. We’ve lost 2,000 residential beds over the last few decades, we have about 300 beds left, none of which will serve children under 13.”
Why do critical services keep falling through the cracks?
“I think it’s always been anemicly funded,” Zaslow said. “We always say as advocates for children, unfortunately children don’t vote. So when policymakers who are all adults are creating systems, whether it’s education systems or other government programs, children are somewhere an afterthought , even if the legislators are parents or grandparents, they are not always at the top of their minds.”
Atchity said what is needed is a long-term commitment to funding. This time, lawyers say the energy is different.
“It’s one of the mysteries of how we do mental health in this country,” Atchity said. “Our interest fades and then there are moments of enthusiastic engagement.”
“We have a moment where there is more awareness than perhaps ever before.”
What was discussed in the Capitol?
Parents like Kari urged lawmakers to pay attention to the long term, not just now.
She was pleased to see that legislation in the past provided assessment tools. She would like to see more education for educators.
“Kids need to be taught about their brains,” Eckert said. “We’re not doing that in our state. There are some states that are. I understand that it takes mandates and it takes money.”
Zaslow said there was a large infusion of COVID relief dollars, and what was important was how the money was distributed. A third of the money went to children, who make up a third of the state’s population.
He also said that the one-time funds will run out soon.
“There’s a group of kids who are going to need extra help because of distance learning, disruption and the stress of parents losing their jobs,” Zaslow said. “And children losing parents and grandparents to COVID. We’re going to need long-term investments.”
Zaslow is talking to state and federal lawmakers about it.
He also said changing the refunds will make a big difference.
He said that under Medicare, doctors are paid closer to the cost of providing services versus Medicaid. It could be anywhere from 60 to 70 cents on the dollar of actual costs.
“People who go into the pediatrics business and serve low-income kids on Medicaid do so knowing they’re going to lose money,” Zaslow said.
But advocates said the energy is different this time, and they hope it makes a lasting difference.
“We have a moment where there’s more awareness than probably ever before,” Atchity said. “The volume of awareness can reach a place where there is unrelenting pressure on leadership to remain attentive to this need.”
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