Lack of psychiatric beds a big problem for children

Neither the commentary, “The recent Md.’s psychiatric bed shortage detrimental to patients and community” (April 24), nor the subsequent letters highlighted the special challenges facing children and youth in need of psychiatric hospitalization and/or residential treatment. It isn’t unusual for these vulnerable young people to wait for several days in hospital emergency rooms before an in-patient psychiatric bed can be found.

For youth with co-occurring intellectual and developmental disabilities and behavioral health issues, the wait can take as long as three weeks, perhaps longer. Endless waits in emergency rooms just add more stress to an already traumatic experience for parents and their special needs children. Psychiatric hospitalizations for children and youth are crisis-driven and generally limited to a week or less. When the medical provider recommends residential care, parents’ only avenue for care is likely to be the voluntary relinquishment of their child to the state’s public child welfare foster care system. These parents, who have been neither abusive nor neglectful, face attorneys and judges as they engage with Social Services to obtain needed care for their children. Should there be no program in Maryland to meet the child’s individual needs and an out-of-state placement becomes necessary, the wait can be interminable.

The attention to court-ordered clients is promising, but we can’t forget about the children. There is a window of opportunity to prevent these vulnerable children from becoming those clients. Along with a strong continuum of community services for children and their families, we also need a system responsive to children with deeper end needs. This includes, when necessary for the safety of the child and/or others, psychiatric in-patient hospitalization and, as rarely as possible, residential treatment and care. These services need to be familycentered, guided by the principles of trauma-informed practices, minimally intrusive, and least restrictive. In the meantime, our children shouldn’t have to wait.