With mental health help scarce, parents are taking their kids to the ER

Posted at 2:25 PM, Dec 10, 2021
and last updated 2021-12-15 12:24:02-05

EMPORIA, Va. — Micale Williams is at ease tossing the ball around with his family in their Emporia yard.

The 10-year-old boy diagnosed with ADHD has his medicine today, but about a month ago, he ran out.

"He gets really bad shakes. His body movement shakes," Micale's mother Michelle Penn said.

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Penn said Micale was scheduled to see a child psychiatrist at VCU Health Community Memorial Hospital Behavioral Health in South Hill. But days before the appointment, the office canceled because the doctor left the practice.

She had just started in March.

"I did ask, could they refill their prescriptions until I figured something out, you know, but no," Penn said. "It would have to be [the doctor]."

Penn tried to get her son's family medicine doctor to write the prescriptions for the ADHD medicine, but "she said she had to get referral papers from the Care building before she could refill their prescriptions."

There are not any other child psychiatrists in the area, so Penn felt she had no choice but to take Micale to the emergency room.

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"Nobody likes to go to the ER, and we had to wait on a school night to get the medicine," she said.

Micale's story is not unique.

Destiny Walls lives in Midlothian and said she has been trying to get her six-year-old son Kylien in with a child psychiatrist since January 2019.

"Everywhere is a six-month waiting list, and by the time the six months comes up, they call and cancel and you have another six months to wait," Walls said. "We ended up going to the ER because I wanted to get him looked at."

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A map from the American Academy of Child and Adolescent Psychiatry showed there is a severe shortage of child and adolescent psychiatrists in Virginia, and elsewhere.

"Part of that is the amount of training and requirements it takes to become a psychiatrist, but the other part of it has to do with what insurance will bill for, what requirements there are within the state for licensure, things like that," Rachel Reynolds, with the Virginia Mental Health Access Program, said.

The problem has gotten worse with more and more children needing behavioral health services since the start of the COVID-19 pandemic.

"We have definitely seen an increase in volume in our pediatric and adolescent populations here," Nelson Smith, the Vice President of Behavioral Health for Chippenham and Johnston Willis Hospitals, a part of HCA Healthcare, said.

"I imagine it is a scary thing to hear your child, if they were to say they wanted to hurt themselves. You don't know what to do, and the first place you think of is your community hospital and your ER," Smith added.

According to a recent survey conducted by the Virginia chapter of the American Academy of Pediatrics:

  • 90 percent of providers reported seeing more behavioral health issues since June 2020
  • 82 percent perceived the number one concern for patients was having access to child and adolescent psychiatrists
  • 62 percent did not feel they were able to meet the increasing behavioral health needs of their patients

"We do know that Virginia is ranked 41st for the availability of mental health professionals and our mental health workforce, and so we know there are not enough psychiatrists or even other mental health providers to meet the growing demand we have," Reynolds said.

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To try to help, a grant awarded to the Virginia Department of Health allowed the state to set up the Virginia Mental Health Access Program (VMAP).

The Virginia Department of Behavioral Health and Developmental Services (DBHDS) manages $5.4 million in funding for the program.

Pediatricians and other front-line doctors who see kids can call VMAP and consult with a child and adolescent psychiatrist about a patient.

"With a 15-20 minute conversation between the PCP and the psychiatrist, they can get the guidance that they need to send the family on their way instead of waiting three to six months to see a provider," Reynolds said.

Reynolds said 648 providers registered to use the system, and the psychiatrists receive six to eight calls per day, but there is still a need for awareness about the free program.

"So, it sounds like a lot of providers may not know about the program?" CBS 6 reporter Melissa Hipolit asked.

"Exactly, we know that we need to do a lot more to get information out to the primary care community about what is available to them," Reynolds said.

Also a long-standing issue, access to inpatient psych beds for children, something Destiny Walls learned about when she took her son to the Chippenham ER.

"I was like, is inpatient even an option at this point because we have been fighting for so long, and they said you would be sitting in the ER for two to five days before getting a bed," Walls said.

"There are kids who wait several days," Nelson Smith with Chippenham said. "We are one of the few places that has child and adolescent beds. There's us, a place in Petersburg. There's just a big shortage of beds for children and adolescents."

Why not add more beds?

So, if there is a need, we asked Smith, why not add more beds?

"That is a good question. There are a lot of places that, I think, yeah, I don't know," Smith replied.

Felecia Wilson, the head of Clinical Services at Chippenham's psychiatrist hospital, Tucker Pavilion, said it would be hard to staff them.

"Staffing has been extremely difficult during this time. I think a lot of our older staff has retired," Wilson said.


This brings us back to Destiny Walls and Michelle Penn.

"It's hard," Walls said.

Both said more needed to be done to help kids in crisis.

"I feel like they should have more resources for the children," Penn said.

To try to help with the staffing issues, this year the General Assembly established a $1.6 million loan forgiveness program for people who pursue behavioral health positions in underserved areas.

Child and adolescent psychiatrists are among the eligible applicants.

VDH said they plan to repay a portion of about 35 people's student loans per year.


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