SoCal hospitals have shortage of inpatient psychiatric beds for kids under 12

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Noah Kemp was three when his violent episodes began. Kicked out of several preschools, his parents sought help from multiple doctors.

At age five, he charged at his mom with a knife.

That year he was diagnosed with bipolar disorder and he began taking medication.

But two years ago when the Orange County boy was ten, things spiraled out of control.

"He was very hyper, he would talk a mile a minute, he was not able to focus on what you were trying to tell him, he was up all night, not wanting to sleep, not eating," recalls Kristin Kemp, Noah's mother.

After a few days, Noah’s parents took him to the emergency room near their home in Mission Viejo. They waited there for three days before a psychiatric bed was found - a two-hour drive away in San Diego.

The Kemps' story highlights a regional problem in Southern California: There is a shortage of inpatient psychiatric beds for kids under 12. There are none in Orange County.

Historically, teenagers have been at the center of discussions about mental health services for youth, but experts say young children can have serious mental health problems long before they hit adolescence, so there is a real need for facilities that can provide those kids with inpatient care.

Stretched to the breaking point

Mental health officials say sending children away from their families for treatment can impede a child’s recovery.

"When a child is hospitalized psychiatrically the treatment of that child really entails parental involvement, so to have a child placed in a hospital two hours away you’re going to have limited contact with the parent and that is not good for the child," says Marcy Garfias, division manager of the Children and Youth Behavioral Health at the Orange County Health Care Agency.

This burdens parents who may not have the resources to be with their child during such a critical time, according to experts.

Kristin Kemp says she and her husband Derek were stretched to the breaking point during the eight days Noah was in San Diego.

"We had to drive down back and forth because we were both working full time," Kristin says, adding that the hardest part was when both parents were at work during the day in Orange County.

"We had many, many calls from doctors and nurses: Noah’s acting out, Noah ran off, Noah is doing this, Noah is doing that, and to know that we’re so far away was just heartbreaking," says Kristin Kemp. 

Not enough beds to meet the need

The counties surrounding Orange County have some inpatient psychiatric beds for kids under 12, but not enough to meet the need, according to health officials. A survey by Children’s Hospital of Orange County, known as CHOC, found that in the five-county region, there are barely more than 100 beds available to youngsters under 12.

Experts say there is not a recommended number of inpatient beds for children under 12, because there has not been a lot of research specific to that age group. But they say there should be 50 beds for every 100,000 kids under 18. In Orange County, which only has beds for adolescents, there are 4.5 beds per 100,000 teens. In the five-county region the number of beds for all minors is 8.3 beds per 100,000 kids.

Research about younger kids includes a 2011 federal study that found psychiatric hospitalization rates rising for kids 5 to 12 between 1996 and 2007.

And according to state data, 2.6 out of every 1,000 California kids between the ages of 5 and 14 require inpatient mental health care. 

Dr. Heather Huszsti, the Chief Psychologist at CHOC, says she has seen evidence of the need.

"We’ve had children as young as six make statements about wanting to kill themselves or harm others in their family," she notes. "I’ve seen one child who was seven who jumped out of a second story window as a suicide attempt and that was her second attempt. Those are the times you’re going to want to hospitalize a younger child."

A plan to build beds in Orange County

The Orange County Health Agency's Garfias says it’s been too expensive to set up inpatient beds for kids under 12.

To address the lack of such beds, the privately-run CHOC is planning to add a pediatric mental health center. Its 18 inpatient beds will be available to kids under 12 as well as adolescents. Officials plan to break ground this fall, and hope to open the center in 2017.

The center, which will coordinate outpatient care as well, is needed because 50 percent of adults with mental health problems first had symptoms before the age of 14, says Huszti.

The Kemps played a central role in getting hospital officials to decide they needed to add the pediatric center. They had shared Noah's story with their well-known pastors Rick and Kay Warren, who head mega-church Saddleback. The two couples bonded over their shared struggles. When Noah was hospitalized the Warrens had recently lost a son to suicide because of mental illness.

"When our youngest son Matthew was diagnosed with clinical depression at age seven our family entered the world of pediatric mental illness, and we understand first hand the pain and the sorrow and suffering that children and their families endure," says Kay Warren.

The Warrens and the Kemps met with CHOC executives and the group formed a task force that has grown to include various county and community leaders.

Plans are underway to raise a total of $11 million for the construction and another $16 million for an endowment. Sandy Segerstrom Daniels, managing partner at C.J. Segerstrom & Sons, committed $5 million. The Orange County Health Care Agency approved  $125,000 toward the plan, and the Warrens promised $50,000.

Not a panacea

CHOC officials say the new center’s 18 beds won’t be a panacea, but will be a good start in helping kids like Noah.

Noah’s parents say he has improved greatly since his hospitalization two years ago. He takes his medication, and he says when he gets anxious he has a trick he uses to calm down: A quote from the bible.

"Lord of himself goes before me, he’ll never leave me nor forsake me, I should not be afraid or discouraged. Deuteronomy 31:8," recites Noah, who adds that he says it to his parents every morning.

"And I always say it to my animals, like we have two dogs and I say Jesus is with them and whenever you feel alone that Jesus is always with you and I think of that for me too," he says.

Noah feels he’s doing better these days, although he admits he still has his moments.

"I still have a little bit of attitude and stuff. My babysitter thinks I’m going into [my] teenage years, that’s why," he jokes.


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