May 10, 2022
Good morning, MindSite News readers. In today’s newsletter, teens in mental crisis are being held in hospital emergency rooms because there are not enough inpatient psychiatric beds – a form of involuntary, windowless boarding that can last for days and even weeks. Private equity investment in mental health is raising eyebrows. And what happens when the website FindTreatment.Gov…doesn’t.
ER boarding for teens a crisis within the pandemic
With inpatient psychiatric facilities short on beds, mentally ill or suicidal teens across the country are being kept in holding centers – also known as emergency rooms. A doctor described the trend to the New York Times as “a pediatric pandemic of mental health boarding” that makes windowless hospital ERs the only option for teens in crisis when it’s not safe for them to go home and no beds are available at nearby treatment facilities.
“Frankly speaking, the [emergency department] is one of the worst places for a kid in a mental health crisis to be,” said pediatric ER doctor Kevin Carney. “I feel at a loss for how to help these kids.” The problem has cropped up at large urban hospitals and smaller rural ones too, with a boarding time of roughly one week on both the east and west coasts. Jessica Friedman, a social worker who helps to place such teens stuck in ER limbo at treatment facilities in Colorado, said a day in which she has only two, rather than nine conversations about where to place a teen is “actually a good day.”
A 2020 National Mental Health Services Survey found that the number of residential treatment facilities for pediatric care fell 30 percent between 2012 and 2020. That number is partly due to policy changes prior to the pandemic, but social distancing rules and staff shortages have exacerbated the problem. Another issue is cost. Executives of Ridgeview and Excelsior, residential facilities in Colorado once offering 700 beds between them, said many were lost, in part, “because reimbursement rates were not high enough to support ongoing operations.”
As more Americans turn to therapy for help, investors seek to turn a profit
As the numbers of people seeking help to manage grief, anxiety, depression, and other mental health challenges rise in the pandemic, investors are turning their sights toward mental health, seeking to capitalize in the growing sector. A new report from the Wall Street Journal suggests that the field has become more attractive to venture capitalists and private equity firms as virtual platforms make therapy and mental health treatment more accessible and insurers pay out higher rates for mental health care. Between 2020 and 2021, the number of behavioral-health acquisitions rose more than 35%, with the vast majority involving private equity firms, the Journal reported.
Investors have poured billions of dollars into everything from online therapy to meditation apps, with nine mental health startups reaching private valuations of more than $ 1 billion dollars last year.
But those investments into mental health care are sparking concern that the push for profit may be detrimental to patient care. Cerebral, an online mental health platform valued at $4.8 billion, has come under scrutiny for reports that nurse practitioners felt pressured to prescribe stimulants. Investors argue that they can help “build large networks and alleviate administrative, technology and other burdens that therapists face,” Eileen O’Grady, research manager at Private Equity Stakeholder Project, told the Journal. But such features don’t amount to better care. “The private equity business model is at odds with the goal of providing quality healthcare,” O’Grady said, because the priority for investors is financial returns.
Outdated data on FindTreatment.gov risky for substance use patients
Cara Poland, an addiction-medicine doctor and professor at Michigan State University, used to present outgoing patients with a paper resource list printed from FindTreatment.gov, a website of state-licensed substance use and addiction treatment providers. She was glad to direct them to a website that offered contact information for mental health providers and clinicians who could provide needed care.
But even though her staff generated the list from a database run by the Substance Abuse and Mental Health Services Administration (SAMHSA) – “the nation’s top substance use and mental health agency” – she soon learned that the information it provided was often no good. Patients were dialing numbers that were disconnected, or seeking appointments with clinicians who no longer practiced, were no longer in the service area, or weren’t accepting new patients.
“It’s scary,” Poland told Kaiser Health News. “Because if you go to use the site, it’s got invalid information. People give up if they can’t find treatment, and we risk losing a life.” She added that the website was “being treated as a gold-standard tool, but it’s not.”
A number of Poland’s peers across the nation agree: FindTreatment.gov needs an overhaul. It’s the first link that comes up when searching Google for rehab support and gets hundreds of thousands of visitors per month, but still lacks both quality filtering options and clear guidance on how to select relevant treatment. SAMHSA said it sends out yearly surveys to providers and uses that information to update the site. But if the agency isn’t informed about needed updates, they don’t happen. When the agency is notified, SAMHSA spokesperson Christopher Garrett said, updates happen within one week.
Still other experts argue that the trouble isn’t so much the addiction treatment website, it’s that there aren’t enough resources to go around. “There’s going to be a limit to its value if everywhere basically has a waiting list,” said Bradley Stein, director of the Rand Opioid Policy Center. The technology may be useful, but more resources need to be directed toward meeting treatment demand, he says.
In other news…
Gabrielle Union and her 14-year-old stepdaughter Zaya Wade have teamed up with the Dove Self-Esteem Project’s #DetoxYourFeed campaign to encourage teens to clear their social media timelines of toxic and detrimental beauty advice. “There is a lot on social media that tells us we need to look a certain way or change how we look,” said Zaya, who is trans and faced many critical posts about her transition online. “I want other teens my age to know that while this type of harmful beauty advice is out there, they don’t need to listen to it and their uniqueness is what makes them beautiful.”
Harvard Business Review wants to help you be a mental health ally at work. Recognizing that many people will experience a mental health challenge at some point in their lives, HBR put together a list of ways to make the workplace a more empathetic space when they do. Suggestions include: reflecting upon and correcting your own biases around mental health and using supportive language when talking to folks who may be struggling. In addition, office executives should consider accommodations like late starts, breaks to attend medical appointments, flextime, quiet workspaces and remote work for all employees when possible.
Need a list of national resources now to identify mental health support for you or someone you know? CBS News gathered this list of family mental health resources in a special report.
If you or anyone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255. And if you’re a veteran, press 1.
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