The light at the end of the tunnel

Over the last few months, we’ve brought to light the lack of emergency psychiatric care options for children in Bexar County. (Please see here and here for a detailed background.) The problem begins when a child experiences a mental, emotional or behavioral emergency. Due to the scarcity of options and low awareness of those that do exist, worried and exasperated parents and caretakers end up taking their children to the only place they can think of – an Emergency Room (ER). In fact, more than 1,300 children experiencing a mental health emergency visit a San Antonio ER each year. While the child and parent are there, they often spend hours waiting…and waiting….only to be turned away because the psychiatric care they so desperately need isn’t available to them. Additionally, Bexar County has a documented deficit of inpatient psychiatric beds for kids available.

This bleak reality leaves way too many of our children at risk.

A December 2014 survey of 300 local health care professionals, conducted in partnership with an experienced research agency, confirmed our concerns about the city’s mental health services. 89% of health care professionals reported access as a problem, with frequent comments like, “I am told no beds are [sic] available.” The emergency setting is likely to exacerbate the situation – it’s not the nurturing and calming setting the child needs. As Primary Psychology’s, “Treatment of Psychiatric Patients in Emergency Setting,” points out, “Upon boarding, psychiatric patients are often placed in extremely loud, hectic environments that may exacerbate many of their pre-existing conditions.”

San Antonio is the country’s 7th largest city, and it prides itself on its vibrant growth, its forward thinking, and on being recognized as one of the South’s Smartest Medical Cities for Groups. We have to do better.

Fortunately, we’re not here today to present this grim picture and leave it at that. We’re here today to bring you good news. 

Today, there is another way.

As shared in our last blog on the topic, many funded projects to improve the delivery of mental health care are occurring throughout South Texas via the 1115 Waiver. Included in these projects are the recent Center for Healthcare Services crisis and respite center for children and adolescents, as well as the expanded services of Clarity Child Guidance Center (Clarity CGC).

Instead of landing in the ER, parents and children now have alternatives. Clarity CGC’s Crisis Assessment Center is a place where a child or adolescent who is experiencing a mental health crisis – whether feeling suicidal or out of control, or exhibiting violent behaviors – can be assessed right away. The child will be evaluated by a therapist, a nurse and a psychiatrist to determine what level of care and treatment he or she needs. It’s a nurturing and calming environment where caregivers can remain with their children during the assessment and observation period. Caregivers are also encouraged to participate in the treatment plan. If it’s determined that the child or adolescent requires acute, 24/7, inpatient care, there will be a seamless transition to an available hospital bed within the 13,500-square-foot living unit on Clarity CGC’s eight-acre campus. And if inpatient care isn’t an immediate need, children can be observed by a team of caring professionals for up to 23 hours, while a treatment plan is created.

Overall, the expansion has added six observation beds and 14 additional acute care beds, which brings the campus total to 66 acute care beds.

Remember those 1,300 children that end up in the ER each year? With the addition of 14 acute care beds, and 6 beds reserved for observation, nearly 1,000 more children will be served by the Crisis Assessment Center.

For families with children that have experienced mental health issues, this is an extremely comforting and reassuring development. “This expansion will help redirect children in crisis from a traditional emergency room setting, which can aggravate the crisis, to a mental health-specific emergency service to address their needs quickly,” said Clarity CGC President and CEO Fred Hines. “With one in five children contending with a mental, emotional or behavioral issue, this is one step to help fill the void in care that exists in our community.”