For House Speaker Nancy Pelosi and members of the Massachusetts congressional delegation on Saturday, Cambridge Health Alliance’s leadership detailed the public hospital's regional response to the mental and behavioral health crisis plaguing young people. 

House Assistant Speaker Katherine Clark hosted the roundtable with representatives Ayanna Pressley and Lori Trahan staged at a long table in a conference room with sweeping window views of Cambridge rooftops and the Boston skyline. Clark organized the gathering to highlight the public hospital’s use of COVID-19 relief money to expand, in part, psychiatric services for children and adolescents. 

Emergency-room limbo

"So we are in a dire situation here,” said the hospital's nurse manager, Janine Hogan, to the congresswomen. “The influx of patients especially youth who are in the emergency department is overwhelming - to say the least.”

LONG COVID: Symptoms linger for many patients  

Demand, especially for inpatient psychiatric treatment, is outpacing available beds, leading to long wait times for children.

"We’ve seen anywhere between 25 and 50 adolescents and children boarding - which means they are here for days," said Hogan.

In February, the median wait time for a child's placement was four and a half days, Hogan said. Last week, the hospital had an adolescent in the emergency department for 15 days. 

Dr. Assaad Sayah, the chief executive officer of the CHA, said Massachusetts Hospital Association shares information about patients waiting for treatment across the commonwealth. 

“This past Monday - there were 650 patients waiting for services - and about 200 were children. We frequently see kids wait for months,” Sayah said. “The child’s life is on hold at that time, and there is nothing really happening."

State Rep. Marjorie Decker, who chairs the Joint Committee on Public Health, did not mince words when she spoke to the need for a better pipeline for treating childhood mental and behavioral health. 

“We would not allow a child to sit in a bed with a broken arm or a bleeding wound, and think that they can wait for days or 15 days, and often weeks, and just say, ‘We'll get there,’” she said, "but that is what we do with children in need of behavioral health care.” 

The Cambridge Democrat is responsible for the development of a monitoring system through the Massachusetts Public Health Department that pinpoints children stuck in emergency-room departments. 

Will trauma be the second pandemic?

Young people have confronted a litany of protracted stressors during COVID-19: Quarantine orders, school closures, missed milestones and social isolation and widespread death. The upending of their lives at a critical period of human development has taken a psychological toll.

“I continue to be concerned that - though we have made great strides on combating the pandemic - the second pandemic will be trauma,” Pressley said. 

More than 200,000 children in the United States lost a primary caregiver to COVID-19. According to Pressley's office: Due to its disparate impact, Black, Latina, American Indian and Alaska Native children are more than four times likely to lose a loved one to the global pandemic.  Experiencing such a tragedy, more than not reverberate for a lifetime. 

A global study revealed the prevalence of child and adolescent depression and anxiety doubled under COVID-19. One in four youth reported having to experience elevated depression, and one in five reported elevated anxiety. Symptoms run the gamut from loss of appetite and low self-esteem to acting-out and suicidal thoughts. 

“It shows up in tremendous aggression, tremendous desperation, depression, self-injurious behavior,” said Dr. Sharmila Mehta, the director of the inpatient child and adolescent psychology and clinical programming. "We're experiencing just this wildfire of pain and suffering." 

For many, Clark said mental and behavioral health vulnerabilities among marginalized communities existed before COVID-19 arrived.

'If you can legislate hate, then we can legislate equity'

Fourteen months into COVID, The Trevor Project reported an uptick in suicidality, depression and anxiety among LGBTQ+ youth - who going into the pandemic were four times more likely to commit suicide than their cisgender, straight peers. The pandemic tethered LGBTQ+ youth to unhealthy home environments where they face parental rejection merely for being who they are. 

"We want to learn from the lessons of this pandemic - where we knew about the vulnerability of that community going into this," said Clark.  "[COVID] has only pulled back the curtain to just show us what we need to do to support everyone  - especially our LGTBTQ+ young people."

Pelosi, who represents San Francisco, is quite aware of the issue. 

"We have a lot of LGBTQ kids under 18 on the street and are homeless abandoned by their families," said Pelosi. 

Clark said she considers the anti-LGBTQ+ bills and laws coming out of Florida and Texas as throwing gasoline on "an already volatile and dangerous situation."

According to Pelosi, passing laws of this caliber and stripe contributes to the mental health crisis. 

"People have to realize the weight, the damage that they do with those things. We have to inculcate against it," said Pelosi. "Yesterday, I was told the more they have these bills and laws - the more suicides we will have." 

The inculcation, in Pressley's eyes, is counter-legislation to the "state-sanction hate."

"So if you can legislate hate, then we can legislate equity. We can legislate justice. We can legislate healing," Pressley said. "And so many other pieces of legislation that create an ecosystem whereby everyone feels safe and affirmed, and they can show up fully, authentically and unapologetically as themselves."

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Original story HERE