As suicide rates among teenagers continue to climb, County Harbor-UCLA Medical Center near Carson is preparing to open the first teen psychiatric emergency room in Los Angeles County.
Hospital officials say the facility will provide a more welcoming environment and comprehensive treatment for adolescents in need of immediate and short-term mental health assistance.
Construction is finished but the final touches are still being put on the space on Carson Street at Normandie Avenue. It’s expected to open in the next few months.
“It was designed to make it as pleasant for the kids as possible,” said Dr. Ira Lesser, chair of the hospital’s Department of Psychiatry. “There are not very many of these dedicated units in the country. We serve the patients now — we just don’t do it in a dedicated area. We’ll be able to have some innovative programs for special interventions and relaxation.”
The Centers for Disease Control and Prevention (CDC) has increased its monitoring of mental health issues among children and teens since 2011, following a nationwide survey that found that 1 in 7 children ages 2 to 8 years old has a diagnosed mental, behavioral or developmental disorder.
The number of suicides among U.S. teens ages 15 to 19 has climbed upward since 2007, according to the CDC. In 2015, 2,061 teens in that age range killed themselves — the highest number since the 1990s.
Suicide threats are the most common reason teens with mental health issues arrive at Harbor-UCLA Medical Center.
“Suicidal ideation is our most common complaint,” said Marcy Borlik, a child and adolescent psychiatrist and the center’s associate director. “Another common complaint is aggressive or behavioral outbursts. Or a child will have some kind of anxiety attack. A lot of our patients are from under-served populations and we see a lot of children in foster care.”
Sometimes substance abuse complicates the diagnosis. Some children arrive in the midst of their first episode of severe mental illness and are hearing voices or are extremely paranoid. Many are learning to cope with ADHD or autism.
Teens ages 12 to 17 can be admitted to the new adolescent psychiatric emergency room, situated behind locked doors next to the adult psychiatric emergency room. Adults and children with mental-health disorders must be kept separate for optimal treatment.
Beyond the entrance, a lobby, waiting room and evaluation room display a local artist’s paintings of downtown Los Angeles, the Vincent Thomas Bridge in San Pedro, and the Manhattan Beach Pier. Construction on the new facility cost about $8 million. It’s situated in the hospital’s former medical emergency room, which was moved to a new building.
“The first step is to evaluate what is really going on,” Borlik said. “Is it depression? Anxiety? Is the kid being bullied or is there a history of trauma?”
After the evaluation, patients can be transferred to colorful waiting rooms with painted skylights and chalkboards covering part of the walls. The rooms have plush recliners, televisions and internet connections. A nursing station provides direct views into the rooms.
There, patients could be prepared for transfer to an inpatient psychiatric hospital if doctors believe they will likely attempt suicide or need ongoing, round-the-clock care.
The facility also comes with increased staffing, and a psychiatric social worker will provide some initial therapy and more comprehensive screening.
Patients can be sent home and referred to an outpatient psychiatric center if they are relatively stable.
Many teens are brought to the hospital by police notified by school officials of disturbing behavior or comments, hospital officials said. They are admitted on a “72-hour hold” but could be sent home early if they are found to be stable, or are referred for ongoing treatment elsewhere.
The psychiatric emergency room will have some beds in case patients can’t be quickly discharged, but it is intended for only short-term visits.
“Twenty to 30 percent of what emergency room doctors see are people with mental health issues,” Lesser said. “The idea is to do a very comprehensive and brief assessment. Patients can be secluded and have a timeout with a staff of psychiatrists. It’s a very different set-up than going to a regular emergency room.”