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Minnesota teenager’s month-long hospitalization highlights challenges facing children in crisis

Angela Reichert’s 13-year-old does not need hospital treatment but has been in hospital for a month – stuck there because an easily triggered combination of autism and aggression makes the teenager difficult to manage for anyone.

Hennepin County regained custody when a series of explosions left the mother too scared to house her teenager. But the county, like the teen’s mother, couldn’t immediately find a group home or residential treatment center that could support the teen.

And so the child, a vulnerable minor who is not named in this story, is sitting at Children’s Minnesota. The Minneapolis hospital offered art projects and games such as virtual bingo, as well as regular weekday access to an educator, but wouldn’t let the teenager out. The strict security and surveillance requirements for a county neighborhood make it difficult.

“I love being outdoors. I love nature,” the teenager said on a conference call Reichert arranged from the hospital room. “I love to go for bike rides, but I don’t need a bike. I can just walk.”

The confinement of children with mental and behavioral problems in hospitals has worsened during the pandemic, with increasing numbers of children waiting weeks or even months for a treatment center to open. The crisis is drawing lawmakers’ attention again this spring as they set Minnesota’s state budget.

M Health Fairview Masonic Children’s Hospital in Minneapolis has seen such a surge of troubled children since last fall that it housed them in an ambulance bay. Southdale Hospital in Fairview also housed a 16-year-old boy for more than 50 days, while a school-aged child has been hospitalized at Ridgeview Medical Center in Waconia for more than a month.

Gov. Tim Walz and legislative leaders on Wednesday announced an additional $60 million in mental health spending over the next four years – giving him a one-time job to ensure he is not traded this week in wider budget negotiations.

However, how best to spend the money and stem the rise in the number of children confined to hospitals is a matter of disagreement. The needs of extreme cases are weighed against the larger group of children requiring outpatient care for anxiety and depression that have been exacerbated by pandemic isolation. Increased investment in school mental health services could improve access, for example, and help children before they are in crisis.

Lack of options

Children’s Minnesota is seeking legislative approval to expand its St. Paul’s Hospital and open a 22-bed psychiatric unit next fall, but will do so even if it has to compensate by closing beds in other areas. More beds would reduce delays, but not necessarily for children like the 13-year-old in the children’s hospital who needs long-term shelter rather than short-term hospital psychiatric care.

State Sen. Jason Isaacson, DFL-Shoreview, has proposed creating a new level of care, the emergency room, that could stabilize children who have psychiatric or behavioral crises but no medical needs. Isaacson came up with the idea after a parent called in distress about a child at risk of self-harm who waited in the ER for days and spent a night in a recliner in the hallway.

“It’s just a traumatic place to be in the first place,” Isaacson said of emergency rooms.

An existing alternative is the Southeast Regional Crisis Center, a drop-off center in Rochester for children 10 and older as well as adults. The center includes 16 short-term residential treatment beds and opened last summer with $5 million in state funding.

While better crisis shelters are needed, an emergency room ultimately replaces one source of temporary boarding with another and does not address the lack of residential facilities and group homes capable of long-term care, said Sue Abderholden, executive director of NAMI Minnesota.

“Children are being assessed in the ER,” she said. “Assessment is not the problem. The problem is that they have nowhere to go.”

Abderholden said group homes and residential treatment centers have agreed to increased state funding to open up available beds for crisis situations. Funding is particularly needed to recruit and retain staff in these facilities, which have closed or reduced beds due to labor shortages.

Regardless of state funding, Abderholden said private insurers can help by paying for care at psychiatric residential treatment facilities, a level of care the state created in 2015 specifically for difficult children.

Scary decisions

Reichert struggled with his eldest child for years, according to court documents. At one point, the child tackled Reichert to the ground, and the mother fought back and called the police for help.

In addition to autism, Reichert’s child was diagnosed with anxiety and disruptive mood dysregulation disorder, meaning chronic irritability and frequent, intense tantrums.

The county’s removal was based on the parents’ inability to provide shelter after a March hospitalization at Masonic Children’s, which occurred after the child assaulted a psychiatrist and was physically aggressive with ER staff. The father tried to get the child in but then had to call police three nights in a row in response to outbursts, court documents show. The mother refused to take the child back out of fear for her 8-year-old daughter.

The decision was agonizing, knowing that she was losing custody and also that there are now court documents accusing her of neglect. Reichert said his child just needed proper support in a community setting and loved poetry, social justice and the ukulele.

The child “feels really, really sad and isolated and ready to come out” after spending his 13th birthday this month in hospital, Reichert said.

A group home in Subway North may soon have room, but Reichert and the teenager try not to hold out hope. The teenager scribbled down sentiments in verse and read them aloud.

“I don’t want sunshine, I need sunshine. I want to experience air and oxygen that I’m not currently getting. I just need justice, not just for me but for everyone in this hospital.”

“It’s beautiful,” said the mother.

“Thank you, Mom,” replied the child.

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