The number of California kids hospitalized with a mental illness has been steadily climbing since 2007. In fact, for California kids ages 5 to 19, the rate of hospitalization due to mental illness increased about 43 percent between 2007 and 2012, according to figures from the Office of Statewide Health Planning and Development.
The graph below, from KidsData.org, shows the striking increase in youth hospitalizations. I've sifted through some of the best research and reporting on this topic, and found some complicated explanations for why this trend might be occurring.
Why hospitalized?
Among children admitted to hospitals for mental illness, depression, bipolar disorder, and psychosis are the most common primary diagnoses, according to an analysis by researchers at UCSF’s Benioff Children's Hospital, and published in April in the journal Pediatrics.
But why are more being hospitalized?
Reporters Jocelyn Wiener, of the Center for Health Reporting, and Phillip Reese, of the Sacramento Bee, dug into this complicated question in February. They write that mental health officials are debating what caused the uptick in admissions:
"Some attribute it to stresses related to the economic downturn, or to increased public awareness of mental illness in the wake of recent highly publicized mass shootings.
But many say the best explanation is that California's young people are not receiving adequate mental health services at two key junctures: before they spiral into crisis, and after they come home from the hospital. Some doctors and parents blame insurance companies; others point to school systems they say are unwilling to pay for high-level care. And still others say the right services often don’t exist at all."
Is there a shortage of treatment options, too?
Yes, according to Wiener and Reese. They describe a shortage of options, including home-based mentoring, family therapy and acute residential treatment. That, they write, has driven up the number of hospitalizations:
In recent years, the state has seen a steep decline in the number of group-home beds, including those that provide high levels of supervision and therapy for emotionally disturbed young people. In 2004, total capacity at group homes was more than 17,000. By the beginning of 2013, because of a combination of financial factors and a philosophical shift toward keeping children in their homes, it had dropped to 11,000.
They spoke with Bay Area attorney Patrick Gardner:
"Where else are they going to go?" Gardner said, referring to those who received the highest levels of residential care. "Those children are going to have to go somewhere. And typically where they go is emergency rooms, juvenile halls or hospitals."
There's a shortage of beds, too
Only 700 of the state’s acute psychiatric hospital beds are devoted to patients under age 18, according to Wiener and Reese.
Bernard Wolfson of the Orange County Register also examined this youth bed shortage and its implications. In Orange County, he found that there are just 32 psychiatric beds for the roughly 725,000 county residents under age 18, and no beds for kids under 12. Kids under 12 who need hospitalization have to go to L.A., San Bernardino or San Diego, he writes.
Wolfson spoke with Kristen Pankratz, educational programs coordinator at the Orange County chapter of the National Alliance on Mental Illness, who said:
"There are parents with adolescents and children who have bipolar disorder or are actively hallucinating, and there's nowhere to take them...This is a huge problem.”
We'll continue to dig into this issue. In the meantime, we encourage you to share your thoughts in the comments section below, or by e-mailing us at Impatient@scpr.org.
