Caught in WA’s youth mental health ‘disaster,’ a teen with nowhere to go

The Mental Health Project is a Seattle Times initiative focused on covering mental and behavioral health issues. It is funded by Ballmer Group, a national organization focused on economic mobility for children and families. The Seattle Times maintains editorial control over work produced by this team.

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Down the hall from where a tiny toddler is playing, past a colorful mural and a nursing station, 17-year-old Jack Hays lies alone in his hospital bed. 

His head is shaved; he recently contracted lice. It’s May, and in the six months since he’s arrived at Mary Bridge Children’s Hospital in Tacoma, he’s gained almost 30 pounds. His room is empty but for a pair of socks discarded on the floor and two cat posters taped to the wall. A staff member is stationed outside his door around the clock, ready to step in when Jack hurts himself — or to call security when he becomes aggressive.

Jack doesn’t talk. But his mother, Greta Johnson, has an intuitive ability to understand what Jack needs. Sometimes they use sign language, but Greta often picks up on a slight movement or facial expression signaling Jack’s feelings.

On this day, his despair is palpable.

Watch: When home is the hospital

Jack’s situation is extreme but increasingly common. He’s one of a surging number of Washington children facing mental health challenges so severe that they require hospital stays. Between 2015 and 2021, the total number of hospitalizations nearly doubled among youth whose primary diagnosis is psychiatric, an investigation by The Seattle Times found. Charges to government insurance for youth psychiatric stays did double, rising to more than $151 million last year.

The Times has spent the past year examining the toll of the youth mental health crisis at Washington state hospitals, interviewing families and medical staff, reviewing state budgeting documents and combing through tens of thousands of records that track youth psychiatric hospitalizations. This data analysis represents the first detailed accounting of the full costs of these kinds of hospitalizations in Washington during the pandemic: the physical and mental costs to the children who are stuck inside hospital rooms, and the financial costs to their families, hospitals and taxpayers.

Housed at the Hospital

In an occasional series, The Seattle Times Mental Health Project is investigating why children are waiting days or weeks for vital psychiatric care.

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State officials have blamed pandemic-era school closures, social isolation and lack of access to mental health services.

But the inpatient data confirms what physicians have reported and national research supports. The youth mental health crisis in Washington crescendoed after COVID-19 arrived — but it didn’t appear overnight. 

Elected leaders responsible for funding children’s mental health services didn’t prioritize these programs even as youth psychiatric hospitalizations were rising many years before the pandemic, a Seattle

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I Compose About America’s Absurd Overall health Treatment Method. Then I Acquired Caught Up in It.

I got a hurried voicemail from my pharmacist in Wisconsin the day before Thanksgiving permitting me know my insurance plan was refusing to address my insulin.

I experienced enough of the hormone that retains me alive to last 17 times.

In my 10 decades dwelling with Style 1 diabetes, I’ve by no means seriously struggled to entry insulin. But in my work reporting on the folks remaining powering by our country’s absurdly intricate wellbeing care procedure, I have composed about how insulin’s steep price tag leads to lethal rationing and about sufferers protesting to deliver all those costs down.

For the most element, even though, I’ve been spared from the difficulties I go over. Perhaps that’s why I waited about a week to contact my new pharmacy in St. Louis, exactly where I not long ago moved for this occupation with KHN.

I’d been waiting around since September for an appointment with an endocrinologist in St. Louis the doctor’s workplace could not get me in right until Dec. 23 and would not cope with my prescriptions prior to then. When I last but not least called a pharmacy to type this out, a pharmacist in St. Louis claimed my new employer-furnished insurance policy would not address insulin with no one thing referred to as a prior authorization. I’ve written about these, too. They’re essentially demands that a health practitioner get acceptance from an insurance enterprise before prescribing a treatment.

Doctors detest them. The American Health care Association has a web-site outlining proposed modifications to the observe, although the insurance policies market defends it as safeguarding affected individual basic safety and preserving money. It feels like a great deal of paperwork to verify some thing we presently know: With out insulin, I will die.

I understood appropriate away the prior authorization would be a issue. Considering that it was a Saturday when I figured out about the need for the authorization, my ideal alternative was to connect with my old endocrinologist’s observe that Monday early morning and beg his staffers to fill out sorts for their now former patient.

I had sufficient insulin to final seven days.

But late that afternoon, I got an automated information from the pharmacy about an insurance plan situation.

Just after shelling out 45 minutes on keep the upcoming early morning, I last but not least obtained by to the pharmacist, who said my insurance provider was nonetheless waiting for a done prior authorization kind from my medical professional. I named the doctor’s office environment to give a nudge.

4 days’ worth of insulin still left.

The selling price of my prescription with no insurance policy was $339 per vial of insulin, and I use about two vials for each thirty day period. Generally, I pay out a $25 copay. Without having the prior authorization, although, I’m uncovered to the checklist price of insulin, as is any person with diabetic issues who lacks insurance policy, even if they stay in one particular of the

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More than 10,000 patients caught Covid-19 in a hospital, analysis shows. They never made it out

They left with covid-19 — if they left at all.

More than 10,000 patients were diagnosed with covid in a U.S. hospital last year after they were admitted for something else, according to federal and state records analyzed exclusively for KHN. The number is certainly an undercount, since it includes mostly patients 65 and older, plus California and Florida patients of all ages.

Yet in the scheme of things that can go wrong in a hospital, it is catastrophic: About 21% of the patients who contracted covid in the hospital from April to September last year died, the data shows. In contrast, nearly 8% of other Medicare patients died in the hospital at the time.

Steven Johnson, 66, was expecting to get an infection cut out of his hip flesh and bone at Blake Medical Center in Bradenton, Florida, last November. The retired pharmacist had survived colon cancer and was meticulous to avoid contracting covid. He could not have known that, from April through September, 8% of that hospital’s Medicare covid patients were diagnosed with the virus after they were admitted for another concern.

Johnson had tested negative for covid two days before he was admitted. After 13 days in the hospital, he tested positive, said his wife, Cindy Johnson, also a retired pharmacist.

Soon he was struggling to clear a glue-like phlegm from his lungs. A medical team could hardly control his pain. They prompted Cindy to share his final wishes. She asked: “Honey, do you want to be intubated?” He responded with an emphatic “no.” He died three days later.

After her husband tested positive, Cindy Johnson, trained in contact tracing, quickly got a covid test. She tested negative. Then she thought about the large number of hospital staffers flowing into and out of his room — where he was often unmasked — and suspected a staff member had infected him. That the hospital, part of the HCA Healthcare chain, still has not mandated staff vaccinations is “appalling,” she said.

“I’m furious,” she said.

“How can they say on their website,” she asked, “that the safety precautions ‘we’ve put into place make our facilities among the safest possible places to receive healthcare at this time’?”

Blake Medical Center spokesperson Lisa Kirkland said the hospital is “strongly encouraging vaccination” and noted that it follows Centers for Disease Control and Prevention and federal and state guidelines to protect patients. President Joe Biden has called for all hospital employees to be vaccinated, but the requirement could face resistance in a dozen states, including Florida, that have banned vaccine mandates.
Cindy Johnson holds a pillow made from a shirt her husband, Steven, used to wear. Steven died of covid-19 in December 2020, and Cindy believes he contracted the virus at Blake Medical Center in Bradenton, Florida, where he was admitted for an infection in his hip. (Eve Edelheit for KHN)
Overall, the rate of in-hospital spread among Medicare and other patients was lower than in other countries, including the United Kingdom, which makes such data public and openly discusses it. On average, about 1.7% of U.S. hospitalized covid patients were diagnosed with the virus in U.S. hospitals, according to an analysis of Medicare records from April 1 to Sept. 30, 2020, provided by Dr. James Kennedy, founder of CDIMD, a Nashville-based
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