MUSC Health data show troubling effects of pandemic era on kids' mental health

December 03, 2020
Girl sitting with arms crossed over her legs looking sad.
An increasing number of young people struggling with mental health issues are ending up in the emergency department during the pandemic. Photo illustration

The coronavirus pandemic era has seen a sharp increase in the percentage of children who come to the MUSC Shawn Jenkins Children’s Hospital Emergency Department with mental health issues. Pediatric emergency medicine fellow Kelsey Allen, who’s keeping track, says it hit 12% in November. 


For comparison, in November of 2019, it was just 2.5%.


Headshot of Dr. Kelsey Allen 
Dr. Kelsey Allen

“They've been quarantined and had their lives upended. It's been hard to see because you want to do everything you can to help children cope,” said Allen, an instructor in the College of Medicine at the Medical University of South Carolina.


The percentage of kids visiting the Emergency Department for mental health help started climbing in April of this year, the same month the coronavirus reached every county in South Carolina. It went from 2.2% in March to 8.7% in April and stayed around that level through May and June. 


After a slight dip in July and August, the percentage of Emergency Department visits for kids with mental health issues jumped to more than 10.5% in September, 11.5% in October and the 12% the hospital just saw last month. Hospitals across the country are seeing the same thing – or even worse, much worse, in some cases.


Dr. Elizabeth Mack 
Dr. Elizabeth Mack

But those are just statistics. Pediatric critical care doctor Elizabeth Mack sees the children and families behind them. Mack, a professor in the College of Medicine, recently witnessed the aftermath of three suicide attempts in three days. “You just feel like you have to do more, like what we're doing is not enough.”


She said what she’s seen shows how important it is for people to keep all medications, prescription or not, locked up, and store guns securely and separately from ammunition.


So what’s going on? Psychiatrist Ryan Byrne, an assistant professor in the Department of Psychiatry and Behavioral Sciences, treats children in the Institute of Psychiatry at MUSC Health. “It's largely related to the pandemic, but I don't think it's solely based on stress caused by the pandemic. I think that's a contributor to it.”


Dr. Ryan Byrne 
Dr. Ryan Byrne

He said a lot of the kids were already struggling with mental health issues when the pandemic hit and lost access to resources such as therapists they normally saw through school programs or in-home psychiatric visits. Some kids in foster care have been getting bounced around during the pandemic, causing even more stress for them. And while virtual visits - online appointments with a doctor - are often an option, not everyone has the technology to participate. So some kids end up with a mental health crisis that sends them to the emergency department.


The E.D. isn’t the only place seeing more young people in psychological trouble. The child and adolescent inpatient unit at the Institute of Psychiatry where Byrne works is often full these days, too. “We now have daily phone calls between the psychiatric providers and the children's emergency room to discuss how many patients are there and how many patients are leaving the unit here,” he said.


Byrne encouraged parents to talk openly with their kids about mental health during the pandemic and beyond. “Tell your children — if you're ever feeling sad, if you're feeling down, you'd feel like you can't go on, you feel like you have thoughts of dying — you always want to be there to support them and get them help if they're feeling that way.”


Let them know their friends’ mental health matters, too. “When talking to children about suicide, discuss the scenario of a friend disclosing suicidal thoughts.  A statement such as, ‘You may have friends tell you they want to be dead or plan to kill themselves.  We know you will have feelings of not wanting to break your friends trust, but it is important you let an adult know your friend is struggling.  You can always discuss a situation like this with us.’”


Byrne said talking about suicide does not make it more likely someone will attempt it. “In fact, the evidence shows that the better the communication, the less likely it is someone will attempt or die from suicide.”


He hopes that publicizing what’s going on will increase that communication at a time when people of all ages are suffering from a pandemic of stress. “We have to get the message spread out about how this is affecting people,” he said, so they can get the help they need – and maybe keep them safe at home instead of the hospital.


Mental Health Resources


  • National Suicide Prevention Lifeline – 800-273-TALK (8255)
  • Crisis Textline – Text HOME to 741741
  • MUSC Psychiatry – 843-792-9888
  • Charleston Mental Health Center - 843-852-4100, Mobile Crisis (emergencies 24/7) - 843-414-2350

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