Bradley Hospital President Dr. Henry Sachs has been an attending psychiatrist at the hospital, treating children with autism and developmental disabilities, for more than 25 years.
Sachs has overseen the expansion of many innovative clinical services and the creation of multiple partial programs at Bradley, a Lifespan Corp. hospital. In his role as the Lifespan medical director for child psychiatry and behavioral health, he has worked toward creating a coordinated systemwide child behavioral health service line.
He discusses the impact of the COVID-19 pandemic on children’s mental health, a growing need for services for increasingly younger patients and a recent grant from The Champlin Foundation.
PBN: The need for children’s behavioral health services in the U.S. had already reached high levels prior to COVID-19, what additional impact has the pandemic had?
SACHS: The reality is, for the past decade, we were already seeing an upward trend in the need for intensive services for adolescents, and that slope is even higher now. Since the pandemic began, there has been a 20% increase in emergency needs among children and 30% for adolescents, which is a population that’s really suffering.
Adolescence can be challenging enough, and now that important period of growth when you identify with your peers and build independence, social skills and relationships is being interrupted. This is developmentally stunting, and that can translate into incredible anxiety.
[Youths] are already experiencing some of the most challenging moments of their lives and COVID is adding layers of distress to this. Young children and adolescents alike absorb the stress of their family and environment, and their notion that the world is a safe place is being challenged. And that’s very anxiety-provoking for kids.
PBN: What emerging needs has Bradley seen over the past year? How has your work changed?
SACHS: Telehealth has been tremendous, and is especially relevant for delivering mental health services and reaching kids we couldn’t otherwise reach. We had already been working on it with an eye to the future, but seeing it all come together when we had to pivot quickly was remarkable. Our virtual attendance with older kids has been very high, and that really speaks to the need and what they’re going through.
With our younger children, we’ve kept a focus on the importance of safely meeting in person and finding ways to move children from waiting list to service. One way we’ve done this is through SafeQuest, a special after-school program that combines group, individual and family therapy with skill group work during the critical afternoon hours. And it has been surprising, and of course alarming, that children needing Bradley’s services are increasingly younger.
PBN: Children needing Bradley’s services are increasingly younger. What is the hospital doing to ensure this population is getting the treatment they need?
SACHS: We’ve been able to expand a number of programs to not only reach more kids but also keep in place the daily structure that is so crucial for children. Our ability to grow our pediatric partial hospital program is particularly important because it will allow children to get the help they need and remain with their family or caregivers. These are kids as young as 2 and 3 years old, and even younger – we don’t want to see them admitted to an acute care setting, which can be traumatizing. Creating additional space creates more access to care.
Across all ages, we’ve ramped up our work with schools to enhance referral methods. Teachers can be incredible advocates for children; they recognize change and may pick up on things before families do. But with not all kids being in school, we needed to train teachers on how to identify a child in crisis without the benefit of having them in the classroom.
PBN: In response to needing to expand services, Bradley received $943,000 from The Champlin Foundation for the Pediatric Partial Hospital Program. What will this support allow?
SACHS: The support from Champlin Foundation couldn’t have come at a better time. It will enable us to increase and enhance the footprint of our pedi-partial program to better serve the rising number of children and families needing it. And it’ll also allow us to grow our children’s partial program by utilizing the space pedi-partial was in previously.
Champlin’s gift, in essence, helps to expand two programs for the price of one. Our pedi-partial program is intensive, family-focused treatment for children as young as 18 months to 6 years with serious emotional and behavioral difficulties. Because our patients are so young, we use the partial hospital level of care rather than inpatient to avoid the trauma of separating children from their parents. Families are heavily involved, and children return home at night able to put into action the plan we’ve developed. Every family is unique, so their ability to go home, test the plan, and come back the next day and talk about it is incredibly important. This helps us fully customize treatment and take into account the many factors that impact families’ lives.
PBN: Looking ahead, what do you anticipate as post-COVID needs among youths? Might there be long-term impacts from the pandemic?
SACHS: I think it’s fair to say that there are two pandemics happening right now – the medical crisis of COVID-19 and the mental health implications we’re seeing and will experience for years to come. The impacts of all of this on the [youths] and families of this country will be felt into the future and we need to be prepared for that.
There are financial impacts that create stressors and exacerbate anxiety; educational losses and the disruption of development. Families will not all rebound from this easily. There will be challenges with reintegrating to what is considered normal and with recovering from an extended period of heightened anxiety and fear; that it’ll be OK to play with your friends again, and OK to not wear a mask. It is critical that care and services be available to address these needs and minimize the trajectory of the lasting impact this time can have on the lives of our families, friends and loved ones.
Elizabeth Graham is a PBN contributing writer.
