BOISE -- Some health care providers say a recent reduction in mental health hospital bed space for kids at Intermountain Hospital is putting a squeeze on other resources in Boise, including emergency rooms.
St. Luke's Children's Hospital says it's had a noticeable increase in pediatric patients with psychiatric issues since Intermountain made the change late last year.
Last week, Intermountain Hospital confirmed to KTVB it has reduced beds that could be used for adolescent patients, removing 17 beds that were used as general overflow. Now there are 30 adolescent beds that sometimes get full, so some families have been turned away to look for another place to go.
It's going to take a lot of partnering from lots of people to address this going forward, said Dr. John Hanks, St. Luke's Medical Director for Outpatient Pediatrics.
Dr. Hanks says it appears on a weekly basis, and St. Luke's is seeing more children with critical psychiatric issues, like suicide attempts. He says the increase came after Intermountain Hospital reduced its inpatient adolescent capacity.
Toward the end of last year, Intermountain Hospital closed about a third of their inpatient adolescent capacity. That's created a situation where the total regional capacity for inpatient care is really limited, Hanks said. So that really does impact the community. It creates a higher load for emergency departments and for other community based programs that are doing triage and trying to assess patients with needs, and what do we do with them when they have mental health needs?
Hanks says Intermountain appears to have only turned people away when another option is given, like St. Luke's.
Intermountain Hospital has a very robust assessment team, so families are unlikely to be turned away without a particularly careful plan, a way that their child's needs can be met in the short-term, Hanks said. If a family is in a situation where for reasons of lack of space the facility at Intermountain isn't available, then we do our best to meet their needs in the interim until space is available.
St. Luke's has always dealt with immediate medical concerns, like an overdose, but Hanks says they are now getting adolescent patients with non-medical, psychiatric-only issues. St. Luke's says it hasn't turned anyone away who couldn't get in at Intermountain.
We're really looking at safety, trying to make sure the child is in a safe environment, that they can be carefully monitored and that their needs, short-term and long-term, can be met, Hanks said. Some of them do have medical needs, so this is a very appropriate place when they have medical needs. If the medical needs have already been met, and we're just trying to find a more appropriate location for their inpatient needs, then that can sometimes take a few days to try and sort that out.
Hanks explains St. Luke's doesn't have the resources, like inpatient psychiatrists, to ideally manage adolescent psychiatric needs for longer periods of time.
We have child psychiatrists, and we have great mental health professionals on the outpatient arena, but not specialized people here in the inpatient facility, Hanks said.
Hanks says that the issue of having enough mental health professionals for children with mental illnesses is not a new problem, nor is it specific to Idaho. He also goes on to say that to help reduce the number of pediatric psychiatric emergencies needing inpatient care, preventative outpatient care should be where efforts are concentrated.
The resources are very difficult throughout the country, Hanks said. In this region, in Boise, and in the surrounding areas, acquiring child psychiatry resources has been a top priority for many years. It's just difficult to attract them. There aren't a lot of child psychiatry specialists that are produced every year, so having that focus and helping to move away from crisis intervention to more appropriate management is I think where the efforts need to be expanded.
Intermountain Hospital did not return requests for an interview Tuesday. Last week, a spokesman said the plans are to use the recently-closed overflow wing for a new, exciting program, but he wasn't ready to give details just yet.