Children's mental health badly harmed by pandemic. Therapy is hard to find.

From June of last year to late this past spring, an average of five children a week were being admitted to the medical school's teaching hospital at East Carolina University in Greenville, N.C., after overdosing on medications such as acetaminophen, opiates, antidepressants and even Ritalin.

John Diamond and his colleagues had never seen anything like it. "Normally," he says, "we see five kids a month."

Diamond, director of the school's division of Child and Adolescent Psychiatry, is on the front lines of a coronavirus-aggravated crisis. There simply aren't enough psychiatrists, psychologists, developmental pediatricians or school psychologists to care for the mental health needs of the country's children, say parents, doctors, and professional associations.

Diamond was as frustrated as he was stunned. The 50-bed hospital didn't have a single bed for children in emotional crises. Kids would have to wait for days in the emergency department and then travel with a sheriff's deputy for up to two hours to another hospital. He also worried about how they would fare once released, since eastern North Carolina's few mental health therapists all have long waiting lists.

"Parents are frantic and desperate," says Nathalie Thandiwe, a public health expert in Los Angeles who counsels families seeking help for children with attention-deficit/hyperactivity disorder and other neurodevelopmental ailments. "Before the pandemic, there were waits of four to six months to see an expert. Now sometimes it's indefinite."

The problem is complex, as are its effects. Pediatricians and nurse practitioners are overwhelmed with mental health crises they're often not trained to handle. Exasperated parents complain that some psychiatrists and psychologists have closed their practices or no longer accept payments through insurance. (Barely half of all psychiatrists now accept private insurance, according to a 2013 study in JAMA Psychiatry.)
Emergency departments have meanwhile become a tattered safety net for adolescent mental health care. One recent study mirrored Diamond's experience, showing that suspected suicide attempts dramatically increased among adolescents ages 12 to 17 last February and March. Girls' visits to emergency departments after suicide attempts soared by nearly 51 percent over 2019, and rose to a high of more than 1,000 weekly visits by spring 2021.

"In the last year, there's been an avalanche of very severely depressed and anxious children and adolescents. It's overwhelming," says San Francisco child psychiatrist Michelle Guchereau, who adds that it has been "heartbreaking" to have to turn some away.

Young people's mental health deteriorated during the pandemic, when cabin fever exacerbated family conflicts and closed schools left children isolated from normal activities and peers.