Children’s Hospital Colorado declares mental health state of emergency as suicide attempts rise

Colorado children are attempting suicide and arriving in emergency rooms in psychiatric crisis at levels never seen in this state, while abuse of alcohol and drugs to cope with mental health struggles is also on the rise.

The youth mental health crisis has escalated to the point this spring that hospital beds are full and more parents are sending kids out of state for treatment, according to a Children’s Hospital Colorado panel of experts who sent up a flare for help Tuesday. 

The hospital system, with a main campus in Aurora as well as branches in Colorado Springs, Highlands Ranch and Broomfield, declared a “pediatric mental health state of emergency.” 

In Aurora, the hospital’s 52-bed emergency department has been overrun with children in psychiatric crisis. Mental health emergency visits were up 90% last month compared with April 2019. The hospital’s transport team is seeing three or four kids each week who have just tried to kill themselves. 

The top overall reason children arrive in the emergency department is a suicide attempt. And on any given day, 12 to 24 children are waiting for an in-patient psychiatric bed to become available. 

In Colorado Springs, the hospital built a 24-bed emergency department three years ago and dedicated six locked rooms for behavioral health treatment. Now, children in mental health crisis are filling 12 or 13 beds, and staff are clearing out rooms in the medical units to make them safe for children who arrive saying they are going to kill themselves. 

“The current system is simply unsustainable and it’s failing our children,” said Jena Hausmann, president of Children’s Hospital Colorado. “Our children need us to rally together.” 

Counties, schools and mental health providers have created “workarounds to a system in our state that simply cannot handle the volume nor the acuity of demand that we are facing,” she said. 

Children’s Chief Medical Officer Dr.  David Brumbaugh, who has practiced medicine for more than 20 years, said that in the last 15 months he has seen a demand in children’s mental health care like nothing he’s ever experienced. Brumbaugh began to cry as he spoke of a dad whose 9th-grade son recently tried to kill himself after not making the baseball team near the close of an isolating first year of high school. 

The boy is the same age as Brumbaugh’s son, who also plays baseball. 

“Our kids have run out of resilience,” the doctor said. “Their tank is empty.” Then he apologized for crying: “I’m sorry, but this is what we are feeling as caregivers every day.” 

In Summit County, where the community is fed up after mourning many youth suicides in recent years, including the death of an 11-year-old in 2017, residents pay into a mental health fund that finances therapy for anyone who needs it but can’t afford it. 

As of April, the county was paying for therapy for 87 children. That’s more mental health vouchers than were issued for kids in all of 2020, said county Commissioner Tamara Pogue. 

The fund generates about $2 million each year, which is not nearly enough to pay for the demand, Pogue said. She called on Gov. Jared Polis’ administration to produce a detailed roadmap for rural communities to build up their own mental health systems — from eating disorder and substance abuse treatment to subsidized mental health therapy.

“Unless we make even deeper and more significant investments, … we will continue to lose more children,” she said. “That is something that I simply cannot tolerate for my community or any community in Colorado.”

Children’s Hospital has ramped up services, hired more mental health staff and is working to add more beds, but the changes aren’t coming fast enough to help the children flooding into the emergency department, said Heidi Baskfield, vice president of population health and advocacy for Children’s.

At the Anschutz Medical Campus in Aurora, the hospital is increasing its in-patient psychiatric beds from 18 to 26 by next March. The campus is also doubling its partial hospitalization program that treats kids for several hours each day, and bumping up beds in its eating disorder unit from 12 to 20. 

In the last several years, Colorado has seen 47 facilities close their doors to youth in mental health crisis, Baskfield said. “At a time when we are seeing volumes increase, severity increase and overall need, the system that is meant to be in place to serve these kids does not only not exist, but those who are attempting to do this work are currently under water,” Baskfield said.

But building more beds isn’t going to solve the crisis, and several experts on the panel said Colorado needs to create an integrated youth mental health system. The state needs to tap into federal pandemic recovery funds from the American Rescue Plan to build such a system, including a patient transfer center that would help hospitals communicate with other hospitals and help families find an available bed, doctors said. The state also needs mental health counselors in all schools, including rural areas, they said.

“We can’t depend on building beds to get us out of it,” said Dr. Mike DiStefano, chief medical officer for Children’s southern region based in Colorado Springs. “If we are building acute beds, we are losing the battle against suicide and behavioral health problems with our teens. We need to be intervening prior to the crisis.”

Colorado lawmakers have proposed spending from $400 million to $500 million of the federal aid on mental health.

For several years, suicide has been the leading cause of death in Colorado for children age 10 and older.

The isolation and stress of the pandemic have exacerbated mental health struggles, leading to higher rates of substance abuse in kids and teens and more diagnoses of eating disorders, said Dr. Jenna Glover, director of psychological training at Children’s. 

More than ever, she said, children are turning to alcohol and drugs to escape feelings or try to find a sense of control, rather than asking for help because they think they will cause more stress for their parents, she said. 

She suggested that parents check in with their children and ask about their mental health at least once every month.

“My largest concern is with the influx of mental health problems that we’re seeing and the demand on the system, kids will not get the treatment they need and they will have chronic mental health problems for years that will impact their opportunities in life,” she said. 

Update: This story was updated on May 26, 2021, to correct the attribution of a quote from Children’s Hospital Colorado President Jena Hausmann.