Addressing the Surging Psychiatric Needs of Youth

May 21, 2022

“Thank you for everything. I thought I’d lost her.”

As the program director at McLean’s newly launched adolescent inpatient program in Middleborough, Massachusetts, Joyce Velt, LICSW, has had dozens of notes, letters, and phone calls from grateful parents expressing similar sentiments.

The idea of losing a child strikes fear into the hearts of families everywhere, and the last two years have seen a mental health crisis of epic proportions, particularly among the adolescent population. McLean has stepped to the plate to address these issues.

A Crisis in Child and Adolescent Mental Health

Younger patients have been particularly vulnerable to anxiety, depression, and other psychiatric illnesses during the pandemic, especially during remote education. Without a structured school day and face-to-face interactions to help navigate the pressures of adolescence, many are slipping into crisis, according to Velt.

“They’re also tapping into their parents’ concerns about the pandemic and the future in general,” she added. “That increases the anxiety levels of kids who are already stressed. Kids who in the past have been able to manage with outpatient care now need hospitalization.”

Wait Times Made Longer by the Pandemic

The backup of psychiatric patients in emergency departments (EDs), long a problem, has worsened as more people are in crisis. In Massachusetts, the bed shortage became so acute that in October 2021, the Massachusetts Hospital Association began tracking the number of psychiatric patients caught in limbo in hospitals across the state. Its weekly report captures how many people were waiting for psychiatric beds every Monday. The numbers ranged from 500 to 650 people statewide at that time, and typically, about one-quarter of those are under the age of 18.

“This is a huge problem,” said Kristen Lancaster, RN, nurse director for the McLean SouthEast at Oak Street Adolescent Inpatient Program. “We get daily phone calls from desperate parents asking for help. Their children are either stuck in the emergency department or at home, in crisis, unable to find a placement.”

3 staff members pose for camera

Mark Longsjo, LICSW, Joyce Velt, LICSW, and Kristen Lancaster, RN

Mark Longsjo, LICSW, knows first-hand how the psychological distress caused by the pandemic is playing out in hospital EDs across the state and country.

Longsjo, senior director of McLean SouthEast, a McLean satellite located in Middleborough also works part-time in an emergency department doing psychiatric evaluations. “Sometimes people are waiting in hallways. The staff is stressed. The system is stressed. Some days have seemed insurmountable.”

McLean has responded by adding a second location to McLean SouthEast. The new 68-bed facility, called McLean SouthEast at Oak Street, offers 22 inpatient beds for adults with depression and anxiety, 24 beds for adults with psychotic disorders, and 22 beds for young people ages 13 through 18.

“We effectively opened up a new hospital, and it’s been wonderful to be able to respond to the need so quickly,” said Longsjo.

This herculean effort has not gone unnoticed or unappreciated. Families are grateful for the treatment and hope that this new program is providing. “Thank you for everything, this is best place we’ve been,” wrote one parent whose child had been hospitalized elsewhere six times. “It is amazing how you’ve worked with my daughter, I thought I’d lost her forever,” wrote another.

Philanthropic support helped the facility quickly move from dream to reality. “Our trustees understand the critical shortage of resources for youth in psychiatric crisis and are deeply concerned by the dramatic exacerbation of mental health issues currently facing children and adolescents,” said Maureen H. Bleday, CEO of the Yawkey Foundation.

“We feel privileged to play a part in supporting the adolescent inpatient program at McLean SouthEast, especially since the much-needed care, hope, and healing provided there closely aligns with Tom and Jean Yawkey’s lifetime commitment to supporting youth with emotional and behavioral health issues.”

A second foundation, which requested anonymity, provided a grant to assist with start-up costs related to hiring and training members of the new clinical teams.

Serving Southeastern Massachusetts and Beyond

McLean has had a presence in southeastern Massachusetts for more than two decades, mostly serving residents of that part of the state, as well as those living on Cape Cod and the Islands.

The new Oak Street building is just half a mile from McLean SouthEast’s Isaac Street facility. Both sites now care for local patients and those from further afield. “We have patients from Boston, MetroWest, and the North Shore,” said Longsjo. “We’re here for all patients.”

While beds in psychiatric settings aren’t always designated for patients with certain illnesses, hospital leadership wanted to reserve the new adult beds for patients with some specific diagnoses, according to Longsjo.

Young woman reads sitting on bed

The new unit at McLean SouthEast at Oak Street includes 22 beds for young people ages 13 through 18

This approach acknowledges that, for example, patients with mood disorders like anxiety and depression may do better with a more specialized approach involving milieu, individual, and group therapy. Milieu therapy involves building a supportive, structured community among patients where they can practice their interpersonal and coping skills.

“We wanted to make sure our care is as person-centered as possible,” said Longsjo.

A Continuum of Care for Adolescents

Between the two sites, adolescents can now access a range of care. The 22 new inpatient beds at Oak Street join the same number of adolescent residential beds at the Isaac Street facility, as well as its partial hospital program. Residential beds are for patients who are less ill than those who require inpatient beds. And partial hospital programs offer full-day treatment, but patients go home in the evening.

“McLean SouthEast now offers an amazing continuity of care for our young patients,” explained Lancaster. “A patient can start on the inpatient unit, then step down to the residential program, then move to the partial hospital program, then home—or the opposite journey can happen. The new space is wonderful and we’re so grateful for the philanthropic support that made it happen.”

If your child is in need of mental health care, McLean is here to help. Call us today at 617.855.3141 to learn about treatment options.

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