Back in the day, there wasn’t anything called “behavioral health” or “mental health.” If there was, you didn’t talk about it.
Parents just told their children to suck it up, no matter what it was, and move on. Sadly, I carried that “suck it up” mentality into my own children’s upbringing, and that’s no longer even close to being acceptable.
Today, mental health is something spoken of on the national news. We are on the lookout for signs and symptoms.
By the Numbers
According to statistics from the National Alliance for Mental Illness, the numbers of people in this country living with mental illness is staggering. One in five adults suffers from mental illness and one in 25 (about ten million of us) lives with a serious mental illness. As many as 43.8 million adults experience mental illness in any given year. These illnesses are non-discriminatory – 9.3 percent of whites live with mental illness, 18.6 percent of black adults, 16.3 percent of Hispanics, and a whopping 28.3 percent for American Indians.
The adolescent statistics are just as alarming. The statistic that stood out to me the most was that one half of all chronic mental illnesses start by the age of fourteen. Fourteen! A full three-quarters start by the age of 24.
One in five children from the ages of thirteen to eighteen either have or will have a serious mental illness. Eleven percent will face mood disorders, ten percent will have behavior or conduct disorders, and a further eight percent will face anxiety disorders.
The stats go on and on. Warning signs for children and teens include continued sadness or being withdrawn for more than a two-week timeframe, overwhelming fear for no reason, severe mood swings, drastic changes in behavior, and much more.
Most of that list includes just being a normal teenager, but the key is to see beyond that. Be more aware of what the young people around you are going through. Listen and learn.
Sue Klebold was the mother of Dylan Klebold, one of the two Columbine shooters. In her book, A Mother’s Reckoning: Living in the Aftermath of Tragedy she discusses how she and her husband were good parents, involved and caring. That didn’t stop them from being torn apart in the press, which kept the public from realizing a deeper horror: how their son could keep his secret, demented inner life from them.
With increased awareness of mental health issues, there is hope that the next Dylan Klebold can receive the vital help he needs before it’s too late.
Brittany M. Lynch, MSW, LICSW, Lead Behavioral Health Navigator, and Medical Social Worker for the Fall River-based Saint Anne’s Hospital, said in her work with patients, she’s finding that there’s less of a stigma and a better awareness of behavioral health issues than ever before.
“There is an increase in the number of persons presenting to the Emergency Department in crisis,” Lynch said. “Whether it’s clinical depression, bipolar disorder, post-traumatic stress, or issues related to drugs or alcohol, clinicians have learned more about these conditions and how to have a compassionate, whole-person approach to caring for these patients.”
This is an important approach – the antithesis of “sucking it up.” Suicide has become the third leading cause of death in youth, and 90 percent of those who die by suicide have underlying mental illnesses. The old way clearly don’t work.
So how is mental health approached in the medical field, or more specifically, in the ER where these cases are seen daily?
“When patients with behavioral health issues come to the Emergency Department, we use a procedure known as SBIRT (Screening, Brief Intervention, and Referral to Treatment), in addition to standard behavioral health assessments, to determine the plan of care,” said Lynch.
“This enables us to provide the best care for the patient at that time and try to refer to the most appropriate mental health or behavioral health providers. Unfortunately, even as more patients present these issues, there are not sufficient community resources, especially as outpatients, to fully care for them, so there is an increase in the number of patients requiring inpatient treatment.”
With an eye toward addressing what is seen as a chronic lack of mental health services for adolescents in the South Coast, Southcoast Behavioral Health recently opened a 24-bed psychiatric unit and plans to open an outpatient treatment center for adolescents aged 13 to 17 once they get approval from the State’s Department of Public Health.
The new unit will be located within the 120-bed psychiatric hospital operating out of 581 Faunce Corner Road in North Dartmouth.
In the unveiling of the new unit on December 9, Southcoast Behavioral Health CEO Kevin Burchill said hundreds of adolescents across the state end up in acute care hospitals that lack the space and specialized staff to treat them. He noted that St. Luke’s Hospital in New Bedford alone averages more than a child visiting the ER in need of mental health services every day.
The new unit will have a number of behavioral health and substance abuse clinicians as well as child and adolescent psychiatrists. Those patients discharged from inpatient will be able to receive services through the outpatient center.
In a subsequent interview, Burchill said 75 percent of Southcoast Behavioral Health’s business comes from ER patients. There are two reasons for this. First is the uptick in substance abuse. But less-known is the Mental Health Parity and Addiction Equity Act of 2008, which prevents group health plans and insurers from treating mental health benefits as different from medical or surgical benefits. If you’re insured, you should be able to get the help you need.
Burchill said that there was a time not long ago when people – some with violent and aggressive tendencies – had to wait three to five days for a bed. They would keep returning to the ER, which could not accommodate them. Burchill said the idea of expanding the psychiatric beds in the South Coast started three or four years ago, when the state’s 900-bed system yielded only thirty beds for South Coast patients.
“They wanted to find a better way to increase access,” said Burchill. People put their heads together and it yielded a Southcoast Behavioral Health/Southcoast Health partnership, creating the 120 bed system we have today.
Of the 120 beds, 72 are for adults, 24 for geriatric patients, and 24 for adolescents. “There was such a demand for geriatric and adolescent beds.” Said Burchill. “The closest geriatric one we had was in Pembroke and the closest adolescent one in South Attleboro.”
“With places like Wareham, New Bedford, and Fall River making up 75 percent of the patients, it takes a big commitment when it comes to inpatient psychiatric needs. Stabilization is a concern – to hop in a car and drive an hour is not a good thing.”
With average stays of eight to ten days for adolescents, Burchill said the new outpatient treatment center will allow for group therapy and psychiatric care in four-hour increments, five to seven days per week, to allow these adolescents a dedicated program that will allow them to remain in their homes while still keeping up with their needed care.
Patients are referred from inpatient settings, family practitioners, school systems, or family care agencies. “In a community at risk,” Burchill said, “there is a need for more intensive outpatient services – an engaged group therapy that may better meet the patient’s needs as an inpatient diversion or discharge option.”
As you can see, Behavioral Health has come far in the last few decades, but there is still more to be done. Just one misdiagnosis could turn deadly. It’s time we all paid better attention to the people around us, many whom may be in need of help. Ask more questions. Pay better attention, but don’t preach and don’t ever say “suck it up.”
Remember, one of every five of your neighbors may just need that help.
Eighty percent of those suffering from mental health problems receive no treatment.
Almost seventy percent of children in the state and local juvenile system have a diagnosable mental disorder.
Sixty percent of those diagnosed with mental illness receive no services. In children and teens, that number’s at fifty percent.