Nationwide Mental Health Crisis for Teens

The Washington Post recently reported the story of Zachary Chafos, an 18-year-old who "languished for a total of 76 days in a Maryland ER waiting for a psychiatric bed." This type of situation is common throughout the country and is a singular example of one of the many contributing factors to the growing mental health treatment crisis for teens in the United States. Partial Hospitalization (PHP) and Intensive Outpatient (IOP) programs, like Compass Health Center, are helping to provide solutions. 

Mental Health treatment spans a continuum of care, with outpatient support on one end and inpatient and residential care on the other. In the middle are PHP and IOP programs, which can provide effective multi-disciplinary treatment to patients needing more than weekly, one-hour support but less than 24/7 care and serve as transition programs for patients stepping down from inpatient and residential care. Compass Health Center's PHP/IOP model was one of the first of its kind in the country and plays a crucial role in treating children, families, and individuals in behavioral health crises without the requirement of a hospital stay. 

"Sadly, Zachary's situation is all too common across the country. Kids are housed in the ER or are moved to medical floors, often staying multiple days without any psychiatric care, until a bed opens in the inpatient psychiatric unit. With the recent surge of RSV cases, even medical beds are full, leaving no other option but to board kids like Zachary in the ER. This is unsustainable as it has a profound effect not only on kids and their families but also the rest of the acute care system," said Alex Timchak, MD, Regional Medical Director, Compass Health Center. "We need long-term system-wide solutions to keep kids in crisis out of the ER. PHP and IOP programs are part of that solution. Compass provides PHP and IOP programs for patients in crisis experiencing symptoms of depression, anxiety, suicidal thinking, trauma, or OCD. Our mission is to have these patients evaluated and initiate treatment within 48-72 hours; in many cases bypassing the need for a trip to the ER." 

The ratio of psychiatrists to patients in need does not even scratch the surface of what is necessary to improve mental health outcomes for American youth. Young people in this country are facing a devastating mental health crisis that was already prevalent before the pandemic but exacerbated by its effects. In the fall of 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children's Hospital Association declared a national emergency in child and adolescent mental health. As reported by The New York Times, "In the United States, emergency room visits for suicide attempts rose 51 percent for adolescent girls in early 2021 as compared to the same period in 2019. The figure rose 4 percent for boys." 

"ER visits and Psychiatric hospitalization should be among the last options when providing mental health treatment for kids and adults. Not knowing if your child can even find a psychiatric bed when kids and families are already in crisis can only exacerbate the strain on everyone. Fortunately, there are good treatment options where kids can see a psychiatric provider within 24 hours of being assessed," said Timchak, MD.

Like all behavioral health programs, PHP and IOP programs can look different depending on where they are offered. Some are attached to large hospital systems and others are standalone practices. It is up to the individuals and families to determine what type of PHP/IOP program is right for them. Where a patient seeks care will also depend on treatment needs, access to in-person care or preference for virtual treatment, health insurance, and a psychiatric assessment by the admitting practice.  

"The goal of intermediate levels of care such as PHP/IOP is to keep kids out of the hospital, at home, and with their families whenever possible. This is what drives our mission at Compass, as it not only speeds time to treatment, but also improves outcomes in these vulnerable kids, and in the end, that's what really counts," said Timchak, MD.

Compass Health Center plans to expand its in-person and virtual treatment options outside of Illinois to Maryland in the spring of 2023. There is an increasing need for comprehensive levels of PHP and IOP care for children, adolescents, young adults, and adults in the mid-Atlantic and across the United States.