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25 Investigates: Staffing shortages leave much-needed mental health beds empty

Dozens of hospital beds needed for patients in mental health crises are sitting empty across the state due to staffing shortages, 25 Investigates has learned.

Many Massachusetts hospitals have been forced to take psychiatric beds offline because they simply don’t have enough staff to put patients in them. It’s one of the reasons children in need of mental health services end up stuck in emergency rooms for weeks and even months, anchor and investigative reporter Kerry Kavanaugh uncovered.

Ivette Monge’s 9 year-old grandson struggled with depression for months and was on wait lists for traditional psychiatric care.

But in February, when she says, she found a note in which he pleaded for help she immediately rushed him to the emergency room at UMass Memorial Hospital in Worcester.

“He left a note. It had a broken heart and said ‘I need help. Please pray,’ Monge recalls.

“He is my everything,” Monge said of her grandson, who she described as a happy, energetic kid who loved to play baseball. To protect his privacy 25 Investigates has agreed to refer to him as A.

But once there, they found themselves waiting too.

“They took us in the back. They put us in a hallway and that was it,” Monge said, adding that they spent hours in that hallway.

As 25 Investigates previously reported, kids in crisis stuck in hospital ERs is a trend commonly called ‘boarding.’

“How many more children like my grandson are suffering?” wondered Monge. “The resources? There’s no resources for these kids.”

There are scores of kids in crisis, like A, who are in ERs waiting for treatment, says Lori Simkowitz-Lavigne, VP of Children Services at Worcester’s Community Healthlink, a UMass Memorial Hospital facility that has seen need soar.

“So on any day, there’s 150 kids waiting in emergency rooms across the state because there’s no beds,” said Simkowitz-Lavigne.

According to data from the Massachusetts Department of Mental Health (DMH), emergency department boarding increased by 200 to 400 percent in June 2020, compared to the same month in the previous year, and remains 2 to 3 times higher than it was pre-COVID.

There are a total of 2,988 licensed psychiatric beds in the state. Of those, 434 are designated for children and adolescents, and, as of December 2021, 105 of them are offline due to lack of staffing, per DMH.

Simkowitz-Lavigne says an already-pressing mental health staffing shortage was compounded by an influx in patients during the pandemic.

“We didn’t have enough staff before the pandemic. We’ve experienced the same as other industries, as far as people leaving the industry. And now more kids are in crisis in need mental health treatment and they need specific mental health treatment. We’re seeing more kids with anxiety, more kids with depression.”

She says mental health staff are experiencing pandemic burnout, and the industry is losing a lot of people to private practice or for-profit facilities that pay more.

A Massachusetts Health and Hospital Association survey of 56 hospitals in late 2021 showed 84 percent of responding hospitals cited “not enough qualified applicants” as a barrier to filling vacancies, and 74 percent said applicants are refusing offers because of low pay.

Over the past year, Governor Charlie Baker’s administration has directed funds to help ease the state’s mental health crisis. As part of his last efforts in his remaining months in office, Baker filed a massive healthcare bill that would invest in expanding and improving access to behavioral health.

Testifying Monday April 11th before the Massachusetts Joint Committee on Healthcare Financing, Governor Charlie Baker laid out key elements of his administration’s Bill S. 2774, ‘An Act Investing in the Future of Our Health.’

“If we were proactively putting resources in the comprehensiveness of our primary care and behavioral health delivery system, we would have a lot fewer people in the ER with no place to go,” Baker told the committee members. “And that is by far the most inappropriate and expensive way to provide care to a lot of the folks that make up the population that we’re talking about here. And, there is definitely something to the idea that in this day and age, particularly when it comes to dealing with some of the issues around addiction and behavioral health care, if you can keep people healthy, if you can provide them with a constant ongoing source of support as they deal with their issues they’re much less likely to end up in what I would describe as the downward spiral that most of the time isn’t really organized to support them, doesn’t do a good job of helping them get back on their feet. And, we simply don’t have an approach to dealing with that other than the court of last resort, which is this case is the ER which is enormously expensive and is not the right answer for them in the first place.”

But for Ivette Monge and many other families like hers, who are in crisis, right now the wait continues.

“These kids are our future. We need to help these kids,” Monge said.

The Worcester grandmother said that after waiting in the ER at UMass Memorial for about 24 hours with no end in sight she opted to check out A and take him to the comfort of a loving home and family.

Since leaving the hospital A has been able to connect with a mental health professional via zoom a few times, she said.

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