Over the past year or so, a friend of mine in Ann Arbor has had to spend quite a bit of time in the emergency room with her son due to various physical and mental issues he’s had to deal with, and the experience has given her some insight into how differently we treat children dealing with psychiatric emergencies from their counterparts suffering from other medical conditions. What follows is the letter which she just recently sent to the leadership of the University of Michigan Hospital in hopes of initiating a dialogue about the way we treat children suffering from mental illness.
Dear Leaders of the University of Michigan,
Last night I took my 11-year-old son to the emergency room at Mott Children’s Hospital. We were treated so well, I was amazed. We were immediately taken back to a room where he was made comfortable on a bed with a choice of age-appropriate movies to watch and an attentive staff specializing in children who made sure that he felt taken care of (he’s completely fine, by the way).
I was amazed because, over the last few years, we have been regulars at the hospital’s psychiatric emergency unit. My son has autism spectrum disorder and major depressive disorder, a combination that makes him vulnerable to pervasive suicidal thoughts and plans. For him, and for our family, this is a very serious matter of life and death. He is an extremely vulnerable child.
The care we received at Mott was such a stark contrast to the treatment that we’ve received in the psychiatric ER. I looked around and wondered, with all of the room in this beautiful hospital, why has there never been a place for my child? When I think about it, I can’t help but cry. Where is the loving atmosphere for children with mental illnesses, who are in such desperate need of comfort?
As you may or may not know, there is no separate waiting room for children in psychiatric emergency. They wait in the same room as everyone else, which of course includes adults with mental illness, who can be scary and unpredictable. I have been afraid to go to the bathroom because I didn’t want to leave my son alone, and have had to wait until a staff member was available to watch him.
When you arrive you can expect to be there for days. In the waiting room. Days. This is because there aren’t enough beds to go around in the state, and you are at the mercy of this bed lottery. Even if you are offered a bed in a facility somewhere, hopefully you are experienced with the system enough to know what some of these other facilities are like, because there are places your child could end up that will make him worse than when he came in. Places where a child with suicidal depression is treated like a criminal, where you are only allowed to visit your child for an hour three days a week. These poor babies. So hopefully you know enough to speak up and advocate for your child. I have literally cried with relief when I was told there was a bed available for him at the University of Michigan. It is more important than winning the lottery.
While you are waiting, there is nowhere for you or your child to sleep. You sleep in a chair in the brightly-lit waiting room while he sleeps on a pile of blankets on the floor, where people have to step around him. Around two a.m., if there is space available, the staff might kindly move you to one of the side rooms, where your child can at least sleep in a reclining chair. By your second night there, you are so exhausted that this seems like a stroke of luck. At this point you may have been in this hospital waiting room for more than 48 hours.
You can tell the seasoned veterans to the ER because they show up with bags of stuff for their kids: pillows, toothbrushes, changes of clothes.
If you are a parent who is fortunate enough to have a partner or family in the area, you have someone to bring you food. If not, hopefully the nurses will bend the rules and order extra food on your child’s tray for you to eat. You may end up with nothing to eat for days.
Most of the staff are very kind and helpful. But some are not. Some treat you like this is not real, like you aren’t in a painful and desperate situation, and your child is a behavioral problem. They are not specialists in helping children. Once we were lucky enough to have a child life specialist visit us. We had been sleeping in the ER for three days. I was so grateful that someone finally treated my son like a sick child, and not as a problem. I didn’t realize that this is something that parents at Mott can just expect.
I know that you can’t fix everything in a day. But there are some important changes you can make that would help families tremendously. Open Mott to children with mental illness. Give them their own waiting room, far from adults who could scare them. Give them their own room to wait in, with a bed, where they can feel comfortable during what will inevitably be a long wait. Provide staff who specialize in pediatric care, who will lovingly and knowledgeably treat these most vulnerable of children. Provide support for families, who are exhausted and scared for their children’s safety and lives.
Please help break the stigma of mental illness and treat these children with the same love and care as all of the other children who come through your doors.