Credit: (newbridgehealth.org)

Mental health services in New Jersey are feeling the strains of the pandemic and its ongoing impact, with inpatient and outpatient services especially fielding high-demand requests for children and adolescents.

The call for services to address a wide range of needs for New Jersey’s youth, from anxiety and depression to self-harming practices and eating disorders, has the attention of state leaders. Gov. Phil Murphy last week announced his new “Strengthening Youth Mental Health” initiative as he began his new role as chairman of the National Governors Association.

But the needs still outstrip the available outpatient services, according to Dr. Stephen M. Scheinthal, the chair for the Department of Psychiatry at Rowan University’s School of Osteopathic Medicine and the president of the New Jersey Association of Osteopathic Physicians and Surgeons. There is also a startling shortage of inpatient psychiatric beds for children with developmental disabilities.

Overall, the mental health crisis for young men and women has grown significantly in the last two years. In 2019, about 36 out of every 1,000 emergency department visits among 12- to 17-year-olds (teens) in New Jersey had a diagnosis for anxiety, according to the New Jersey Hospital Association’s Center for Health Analytics, Research and Transformation (CHART).

That number went up to 49 per 1,000 in 2021, about a 36% increase. Additionally, the proportion of depression-related emergency department visits among teens increased by about 38% from 2019 to 2021, and the proportion of depression-related hospitalizations rose by 25%.

“New Jersey is one of the most resource … rich states for mental health in the United States, but even here, things are just overburdened at this point,” said Dr. Lydia Vender, a board-certified child and adolescent psychiatrist at Rowan University’s Child Abuse Research Education and Service (CARES) Institute.

Credit: Edwin J. Torres/ Governor's Office

A state and nationwide need

Data from the Centers for Disease Control and Prevention stated that in 2021, more than a third (37%) of high school students reported they experienced poor mental health during the COVID-19 pandemic, and 44% reported they persistently felt sad or hopeless during the past year.

“This has been one of the invisible tolls of COVID-19 — the mental health impacts brought on by isolation, fear, loss and the myriad other challenges our youth have faced,” said Cathy Bennett, the president and chief executive officer of the New Jersey Hospital Association (NJHA), a nonprofit trade association.

“The impact of social media must also be taken into account, especially as youth turned to those forums for social interaction during the pandemic. Unfortunately, those interactions very often are unhealthy and contribute to the stress, anxiety and depression among youth.”

Dr. Edward D. Spector: ‘This is a terrible gap in services. If there were more child and adolescent psychiatric inpatient beds available…it will provide valuable psychiatric services in a timely manner to our most vulnerable mental health patients.’

To address these needs, hospitals and medical providers throughout the state have services in place and are moving to add more.

• Inspira Health Center in Bridgeton is partnering with the state Department of Health to add 19 additional adult voluntary beds for inpatient psychiatric services, according to Kimberly Talley, the vice president of patient care services. The goal is to have these beds operational by June 30, 2023, according to David Moore, the assistant vice president for the behavioral health service line for the Inspira Health Network.
• At Hunterdon Health in Hunterdon County, there will be an expansion of the emergency room department, which will include eight new behavioral health beds that are being constructed and will be available at the end of November, according to Dr. Edward D. Spector, the chairman of emergency medicine at Hunterdon Medical Center.
• Bergen New Bridge Medical Center in Paramus, the state’s largest inpatient psychiatric program, opened The Hope and Resiliency Center for Youth last fall, providing outpatient services to adolescents that includes counseling and group therapy two to three times a week, according to Deborah Visconi, the president and chief executive officer of Bergen New Bridge Medical Center. About 100 children and families have benefited from the center, according to Donnalee Corrieri, the chief communications and marketing officer at Bergen New Bridge Medical Center.

“We’re still seeing lots of calls coming into our access center for people seeking help,” Visconi said. “So that demand is still there, and … I don’t see it going away anytime soon.”

In order to offset emergency room visits, ongoing efforts are being made to address the needs of people experiencing a mental health emergency through early-intervention support services (EISS). These are short-term mental health services for adults who are having serious psychiatric or emotional distress and need immediate intervention.

In April of this year, the Department of Human Services awarded a total of  $10 million in contracts to mental health agencies to expand early intervention support services. This funding will allow for the expansion of services to 10 additional counties so that each county in the state will eventually have the service.

One of the recipients of that funding was Comprehensive Behavioral Healthcare, a community-based behavioral and mental health service provider and private nonprofit organization that has done early intervention support services in Bergen County for about nine years, according to Susan Devlin, the executive director of the organization. The organization has been awarded $1 million to open another mental health urgent clinic in Passaic County that will provide early-intervention support.

Where gaps remain

But critical gaps for child psychiatric services remain, including a lack of child psychologists statewide.

“At Hunterdon, as in many other counties, children and adolescent patients in acute mental health crises can at times wait up to one week or more in the ED (emergency department) before a psychiatric inpatient bed becomes available,” Spector said.

“This is a terrible gap in services. If there were more child and adolescent psychiatric inpatient beds available, it would not only ease the burden on NJ emergency departments, it will provide valuable psychiatric services in a timely manner to our most vulnerable mental health patients,” he added.

There are a total of 304 inpatient psychiatric beds for children and adolescents in the state, according to Nancy Kearney, the deputy director in the office of communications at the New Jersey Department of Health.

But, only 10 inpatient psychiatric beds are available statewide for children with developmental disabilities, according to Dr. Scheinthal. These beds are located in Elizabeth at Trinitas Regional Medical Center, which is now part of RWJ Barnabas Health.

“I think the one thing where there is a major shortage and need is in the developmental disabilities and elderly patients living with dementia. Those who are being discharged from nursing homes, for example, and assisted living,” Visconi said. “I think there’s definitely — I don’t think, I know — that there’s a shortage of beds and a shortage of services for those individuals.”