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Children's Minnesota to open inpatient psychiatric unit

Star Tribune - 10/4/2021

Children's Minnesota is opening an inpatient psychiatric unit next year in response to rising levels of pediatric depression, anxiety and other mental disorders that have been exacerbated by the social disruptions and stress of the COVID-19 pandemic.

The 22-bed unit will open next year in St. Paul, bringing the state's largest pediatric provider into the inpatient mental health arena.

"As the kid experts, it's our duty ... to address this crisis and support families with the full spectrum of pediatric resources they need," said Dr. Marc Gorelick, president and chief executive of Children's.

While mental health-related visits to Children's emergency departments dropped slightly from 1,757 in 2019 to 1,729 in 2020 — when the pandemic prompted declining hospital usage for many conditions other than COVID-19 — the pediatric provider is projecting an increase by the end of 2021. Based on 551 visits through the first quarter of 2021, the system is projecting a total of 2,204 by year's end.

Limitations on in-person learning, social gatherings and extracurricular activities in response to the pandemic have been tough on children and their social and emotional development over the past 19 months, said Dr. Rob Sicoli, director of Children's emergency medicine.

"The need to provide more mental health resources to the pediatric community was present prior to the COVID pandemic," he said. "It was a definite need and it's only been amplified by the effects of the pandemic."

Brooklyn Park-based PrairieCare also announced this summer that it is expanding its 71-bed child psychiatric hospital by 30 beds. That expansion followed a decision by the Minnesota Legislature this summer to waive the usual government review of hospital expansion proposals in order to gain more inpatient mental health beds in the states.

Between the two expansion projects, Minnesota's inpatient pediatric psychiatric capacity will increase by more than 2,200 patients per year.

The "intensity and complexity" of child psychiatric disorders already were growing, but the pandemic added new sources of stress — including for parents whose feelings rubbed off on children who were at home more often, said Todd Archbold, PrairieCare's chief executive. Summer historically has seen a decline in inpatient pediatric psychiatric usage, but that hasn't happened the past two summers.

"During the thick of quarantines when the pandemic was really ugly last winter-spring, I think a lot of the stress that parents and caregivers had been holding had been kind of rubbing off on kids, if you will," Archbold said. "You know, they pick up on those things ... and they were spending a lot more time together because they weren't in classrooms and they weren't at soccer practice and so forth."

Children's inpatient expansion follows the opening this summer of a day treatment program for teenagers at its outpatient facility in Lakeville. The pediatric provider has been centralizing many of its mental health resources in St. Paul, which also houses treatment centers for eating disorders and developmental disorders.

Sue Abderholden of NAMI Minnesota supported the expansion, noting that a lack of inpatient beds left many children "boarding" in emergency departments until they were stable enough to go home without treatment, or with referrals to make appointments later.

"We've waited a long time for Children's to embrace the fact that they need to be attending to the acute inpatient mental health needs of these children too," she said.

Minnesota leaders have been wary of inpatient psychiatric expansions, hoping instead for alternatives that keep patients from suffering crises and needing hospital admissions in the first place.

The state blocked a proposal in 2007 by PrairieCare (then Prairie-St. John's) to build a 144-bed adult and child psychiatric hospital in Woodbury, based largely on a preference to solve Minnesota's mental health treatment shortage with outpatient alternatives.

But even at that time, state health research noted a specific shortage of inpatient psychiatric beds for children. And a subsequent report by the Minnesota Hospital Association showed that child mental health-related ER visits rose from less than 10,000 in 2007 to nearly 20,000 in 2016.

Solutions have been erratic, though. Cambia Hills of East Bethel was a much-anticipated 60-bed intensive residential treatment facility when it opened in April 2020. However, it closed abruptly in June — with its operators blaming the state for a lack of a payment rate increase, and state regulators noting that it had already been cited for regulatory violations of patient care standards.

Jeremy Olson • 612-673-7744

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