It comes as no surprise that the mental health crisis has been deepened through the pandemic; isolation, lack of normal routine, and overall negative news have caused harm to teenagers’ mental health. Those with eating disorders, depression, and anxiety have worsened, and many who had previously not struggled with these disorders have begun to experience symptoms of mental illness.
With the rapidly declining mental health for many, psychiatric facilities and treatment programs have faced an overwhelming number of adolescents needing to enter these programs. There are four main levels of psychiatric care for teens: inpatient, residential, partial, and long-term programs. Inpatient hospitals provide treatment to more severely ill mental health patients who immediately need a higher level of care to ensure their safety and stabilize their mental health. Residential programs typically are less intense, and provide a more comfortable, home-like setting, as opposed to inpatient, which is located in a more secure part of a hospital. Inpatient treatment consists of 24/7 monitoring, while residential treatment consists of monitoring, but not quite on a 24/7 intensity. Partial programs are when people need extra support, but do not necessarily need to be monitored in a hospital setting. In these programs, participants attend during the day but are able to continue living at home. Long-term programs (specifically Intensive Residential Treatment Programs or Continuing Care Units) are for patients who need longer-term care in order to get their mental health into a more stable condition, so they typically stay in these treatment facilities for 4-9 months.
Since the pandemic, all levels of psychiatric care have been drastically changed to ensure the physical health of staff and patients. Unfortunately, these changes have made already challenging facilities to be even more difficult to bear. Patients usually rely on family visits, friends made in the hospital, and comfort items to help themselves through this hard time in their life, and COVID-19 has (negatively) affected the programs.
All overnight facilities have had to put restrictions on family visits. At the beginning of the COVID, most facilities did not allow in-person visits at all in an attempt to prevent COVID outbreaks. This is particularly difficult when patients are already severely struggling with their mental health; it further isolates them from their normal life when they are unable to see their loved-ones, an important part in the healing-process. Now, some of the overnight facilities have opened up family visits, but the visits have a lot of regulations, often including: being outside, staying six feet apart, no touching, and shorter visit times.
Also, in many places, staff are required to stay in the facility for longer periods of time. Typically, most staff were allowed to go home for the night, as a separate night crew would take over monitoring the patients. Now, though, many facilities have evolved: staff now take on shifts for multiple days in a row in order to limit the number of people going in and out. This can make the staff more on edge, which in turn makes the experience for patients worse. Similarly, many partial programs have turned to be completely online, which is clearly not an effective way for people to receive the treatment they need.
Another way inpatient and residential facilities have changed is limiting the number of objects patients are allowed to have in the hospital. In the past, patients could bring in comfort items like stuffed animals, blankets, books, games, etc., but COVID has restricted the amount of items that can be brought. Again, patients often rely on these items, and not having them makes staying at the hospital even harder.
Obviously, patients and staff at inpatient, residential, and partial programs that are in person are required to wear masks at all times and stay socially distanced. Patients are also split into smaller groups to eat or take meals into their rooms so that when patients are without a mask, they are not with many other people. At some long-term facilities, though, masks are not required, given there is not a constant rotation of patients like at other programs.
Perhaps the greatest difficulty mental health facilities are facing is the number of patients needing to be admitted. In the past, patients did not have to wait in the ER long before they were able to get a bed at an inpatient hospital (typically two days to a week). Now, though, some are forced to wait many weeks to be admitted into psychiatric hospitals -- this waiting period costs money, which is particularly hard on lower-income families. For residential and partial programs, some patients are transferred from an inpatient unit, but typically come from their home to receive more intensive treatment. Before, waiting lists were long, but you could usually get into a treatment facility within a few days/weeks from an inpatient unit, or a few weeks to months from home. However, now the waitlist for these programs can be over six months, an incredibly long wait for people who urgently need help.
The mental health system was already in need of improvements, and the pandemic has only made the situation worse. Changes need to be made, and now.
*Note that the regulations at facilities are constantly changing, so rules could have changed since the writing and research done in this article.