In this episode of Kids at Risk Action, the hosts address the growing mental health crisis in child welfare, particularly in emergency rooms and foster care systems. They reveal alarming statistics, such as the significant rise in ER visits for children’s mental health crises and the systemic failures that leave many without proper care. Factors such as poverty, childhood trauma, racial disparities, and long wait times for mental health services exacerbate the problem, leading to repeated crises for vulnerable children. The episode emphasizes the need for proactive solutions, including expanding access to mental health care, training more professionals, and creating mobile crisis response teams to intervene before emergencies arise. The hosts call for increased awareness, better policies, and greater investment in child welfare to break the cycle of trauma and provide lasting support for at-risk children.
Check out the Tip of Children Mental Health Iceberg podcast.
Audio Transcript below:
Welcome to the kids at risk action podcast, where we dive deep into the pressing issues affecting vulnerable children across the country today, we’re exposing a hidden crisis, one that plays out in emergency rooms, foster care systems and behind closed doors. That’s right, we’re talking about the mental health crisis in child welfare. Every year, 1000s of children cycle through emergency rooms, not because of physical injuries, but because of mental health emergencies, suicidal ideation, self harm and severe behavioral breakdowns. But here’s the thing, this isn’t just an ER crisis, it’s a systemic failure that’s leaving children without the help they desperately need. We’ll break down the numbers, the causes and the real life consequences of a system that’s overwhelmed and under resourced. And most importantly, we’ll explore what we can do to change it. Let’s get started. Let’s start with the facts. Emergency room visits for children’s mental health crises have skyrocketed in 2020 alone. There was a 24% increase in ER visits for children ages five to 11, and a 31% increase for kids 12 to 17, that’s just in one year. And if you zoom in on kids involved in child protective services, the numbers get even more alarming. A staggering 33% of children in the welfare system visit the ER for a mental health crisis at least once, and for some The ER is their only contact with mental health care. That’s because many of these children don’t have access to therapy or psychiatric care before their situation becomes an emergency. In fact, only 24% of children receive any mental health follow up treatment within 30 days after an ER visit,
which means once they’re discharged, they often end up right back where they started. So why is this happening? Why are children in such extreme distress that they’re ending up in the ER, it’s a combination of factors such as extreme poverty. Childhood Trauma in these homes is common. The high incidence of adverse childhood experiences is common among these children, trauma changes brain function in these children. They need help to end the trauma and heal without help, many of them go on to lead dysfunctional lives. Suicide is now the second leading cause of death among teenagers. There are also racial and gender disparities. Studies show that chemical restraints, meaning powerful sedatives and antipsychotic drugs are used disproportionately on black children and young males. That’s deeply concerning, children often wait up to six months for outpatient mental health services, with some patients waiting as long as a year and a half to see a clinician. In many communities, children are forced to wait days or even weeks in hospital emergency departments while waiting for psychiatric beds. Rural Areas face especially long wait times due to limited mental health services and the need to travel long distances for care. For families without insurance, there is often no support available beyond the emergency room at a local hospital, for rural children, this can mean enduring long trips during a time of catastrophic mental health crisis and COVID 19 made everything worse. Lockdowns trapped children in unsafe homes away from teachers, social workers and other mandated reporters who might have intervened,
which means millions of children were suffering in silence. Here’s the truth, ers are not built to handle pediatric mental health crises. The average wait time for a psychiatric admission 18 hours, more than triple the time for a physical health emergency. And when ers are overwhelmed, they turn to a last resort, chemical restraints. These are drugs used to sedate kids who are struggling, and while they may stabilize them temporarily, they don’t address the real problem, which is why so many of these kids keep coming back. ER doctors see them over and over again, because the real issue, the trauma, the instability, the lack of mental health support, isn’t being addressed. And for some children, their ER visit is the first and only time they receive mental health care at all. Let’s be clear, this isn’t the fault of social workers or ER doctors. These are professionals doing their best in an overburdened system.
The real issue is that we have a system that’s reactive instead of proactive. We wait until a child is in crisis before stepping in instead of providing the support that could prevent the crisis in the first place. In the lack of outpatient and long term mental health care means children cycle through crisis after crisis. Families have nowhere to turn many caregivers, foster parents, group homes, even biological families, bring children to the ER not because they want to, but because they have no other options. We’ve talked about the problem. Now let’s talk about solutions. Number one, expand mental health care access. That means more community based mental health clinics, more crisis intervention programs, and more in home therapy options, so that children don’t have to reach the point of emergency. Number two.
Two, train more professionals. We need more child psychiatrists, more trauma informed therapists and more school based counselors. Number three, rethink how we handle crisis situations instead of relying on ers and police intervention. We need mobile crisis response teams, trained professionals who can de escalate situations without restraint or hospitalization. And finally, we need to start talking about this. The reason this crisis continues is because it’s hidden. If we don’t address this now, the consequences are severe. We’re talking about higher suicide rates, more children entering the juvenile justice system, and generations of trauma continuing unchecked, but change is possible. It starts with awareness. It starts with demanding better policies, better funding and better care for our most vulnerable children. If this conversation resonated with you, we urge you speak up. Share this podcast, contact your representatives and support organizations fighting for child welfare reform together, we can make a difference. Thanks for joining us today on kids at risk action. Please make sure to visit our website for more information on this topic and ways that you can help make a change.
Contribute to CASA MN
