Overburdened Kids’s Psychological Well being Professionals Really feel COVID’s Pressure

Gabriela Rodriguez stands in her office and points out letters of thanks and souvenirs from her time as a child psychologist. She says there aren’t nearly enough child mental health professionals to meet current needs.

In her office at Riley Children’s Hospital, the waiting list is months long.

Rodriguez says more children are seeking mental health services during the pandemic. But with waiting lists, help is delayed at a crucial moment.

“It’s really a challenge because we know the sooner we get help, the better,” said Rodriguez. “So any time you spend waiting is unfortunately wasted time.”

Even before the COVID-19 pandemic, it was problematic to find help. Looking at the outlook for 2018, a federal agency reported that one in ten children in America has a serious emotional disorder. Only half of them are treated.

COVID has put even more stress on children – such as dealing with the virtual school, mask requirements and the fear of losing loved ones. Now families with acute and longstanding problems have difficulty finding treatment.

“So five years ago the population was six for the state,” said Dr. Michael DeMotte, program director of the IU Health Psychiatry Residency. “And now we’re at 24, certainly positive growth in that regard.”

But the increase is unlikely to have any impact anytime soon. It will take years for these new residents to fully enter their careers, and youth and child psychiatrists will need an additional two years of school.

Psychiatrists also tend to be older than other doctors – and they leave the field faster than we can train them. One study estimates that around 2,600 psychiatrists will retire in 2024 and only 1,800 new ones will be replaced.

DeMotte said young doctors could quickly become overwhelmed by the demand.

“For a resident doing inpatient work, they can be limited to eight or ten patients, depending on the training location,” said DeMotte. “While after graduation, the practitioners take care of twice as many every day.”

That demand has made it common to see four to six month waiting lists in Indiana.

The American Academy for Adolescent and Child Psychiatry says there should be 47 child psychiatrists for every 100,000 children. Indiana has only 6 in 100,000 children.

There is another factor that can make psychiatric care inaccessible to some families: psychiatrists who forego insurance. This forces patients to pay out of pocket, which can be prohibitively expensive.

The reasons for going down this route are complicated, but often it is a doctor’s response to insurers’ low reimbursement rates.

“Which then puts pressure on the practices to see more patients faster,” said IU Health psychiatrist Diane Reis. “And in psychiatry it’s really a challenge because a lot of our work is built on relationships.”

By not purchasing insurance, providers can charge more and avoid rushing patients into 15-minute appointments.

The increased demand goes beyond psychiatrists as other providers of mental illness are also feeling the strain of the pandemic. Counselor Rebecca Peters, who runs a child and youth practice in Lafayette, Indiana, says she has seen more issues such as acute stress and PTSD-like symptoms due to the pandemic.

Peters said, like all of her colleagues, her waiting time is long.

“I’m telling you, I hate returning calls,” said Peters. “Because I start with: ‘I don’t have any new customer appointments until August.'”

Some experts hope that innovations like telemedicine will make it easier for people to be treated. And Rodriguez, the child psychologist, said she believes lawmakers can make it easier by funding comprehensive services for children.

New federal funding created to fight the COVID-19 pandemic will support community-owned mental health centers. However, some experts warn that the pandemic’s stressors will still be felt for years – and the full effects are still unknown.

This story is the third in a three-day series produced by Bridge Michigan and WFYI’s Side Effects Public Media in association with the Institute for Nonprofit News. The project was made possible by a grant from the Robert Wood Johnson Foundation with additional support from INN’s Amplify News Project and the Solutions Journalism Network.

To read all of the stories included in the project, click here.

Contact the Side Effects reporter Carter Barrett at [email protected] Follow on Twitter: @carter_barrett.

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