The Change Teens Need In the Mental Health System

There are many agencies and organizations that attempt to address the mental health needs of teens. Aimed a reducing teen suicide or altering the long term course of mental illnesses which start in the teen years, groups set a mission to prioritize teen mental health. 

But in a crisis, the most important need for a teen is still the hardest to meet: Immediate access.

Sure, a teen can seek admission to a mental health hospital, but many will be turned away, not meeting the criteria for eminent risk that admission requires. And those who are admitted are often only in the hospital for 3-5 days. Then what?

When families wait long periods, often 3-6 months, to see an outpatient psychiatrist for an opinion in the midst of a crisis, the needs of youth are not well served. During those months some of our teens are caught in the revolving door of hospital re-admission, not benefitting in any substantial way from the short bursts of treatment available inside. Others boil over into behavioral crisis and end up caught in the legal system or sent away by parents to places like military school and therapeutic residential programs. 

Immediate services affect teens uniquely; often because of the ways teens’ emotions are distinctive from other groups. Pruning of neurons at puberty can abruptly disrupt emotion regulation. Teen peer relationship can feel overwhelmingly intense, and bullying or even simple rejections can cause devastation and result in suicidal crisis. Distressed teens can contribute to an atmosphere of tension, fear, and conflict in their homes when all they really need is immediate treatment support, answers, and reassurance for their parents from a qualified professional team. Care is usually available, but it comes with months of waiting, and that waiting intensifies the crisis for teen and family.

But how can we get teens seen for non-hospital services when they are in crisis? How can we reduce wait times for new patients, and still meet the needs of the vast numbers of psychiatric patients who need ongoing care?

Here are a few of the changes that can help:
•    Create dedicated crisis outpatient programs and reserve adequate time for walk-in traffic
•    Refer stable patients back to primary care for ongoing treatment when possible
•    Refer straightforward cases back to primary care, to reserve limited psychiatric care spots for the severely mentally ill or those in urgent crisis
•    Allocate resources to those with the greatest need, rather than those with the right coverage
•    Change the conversation among policy makers to address the distinct, nuanced nature of the immediate crisis as a separate problem from longer treatment for the severely mentally ill
•    Coordinate care with support professionals, such as psychotherapists, to monitor and refer

Posted on February 8, 2016 .