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‘No wonder nobody seeks help’: Is SC lacking mental health care options for children?

The signs of anxiety and depression. A discussion on youth and mental health

Jennifer Katzenstein, director of psychology and neuropsychology for John Hopkins All Children's Hospital, speaks on common mental disorders.
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Jennifer Katzenstein, director of psychology and neuropsychology for John Hopkins All Children's Hospital, speaks on common mental disorders.

When Shannon Norman Walker took her foster child to the hospital for a mental health emergency, she didn’t know much about the state of South Carolina’s mental health care system.

But after seeing her child spend more than a week waiting at Conway Medical Center for a spot to open up in a Psychiatric Residential Treatment Facility, Walker is ready to push for change.

Anna Maria Darwin, an attorney for Protection and Advocacy SC, an organization that advocates on behalf of mental health patients, said the lack of available psychiatric treatment services for children in South Carolina has long been an issue.

The South Carolina Department of Health and Environmental Control lists 11 private facilities in the state licensed to provide a total of 624 beds for children and adolescents, with the closest facility to Horry County being the Palmetto Pee Dee Residential Treatment Center in Florence.

A few of the facilities reached by The Sun News confirmed that they regularly run at or near capacity, and commonly have lengthy waiting lists. Lengths of stay once admitted vary widely depending on the diagnosis of the child and availability of resources close to home.

The state Department of Mental Health also oversees a public facility, the William S. Hall Psychiatric Institute at Bryan Psychiatric Hospital in Columbia.

The waiting list at the institute included three for boys 12-17 years old and five for children 4-11 years old, according to department spokeswoman Tracy LaPointe.

“The unit of Hall that tends to have the longest waiting list is for the younger children,” LaPointe wrote. “In this unit, as soon as a discharge takes place, a patient is admitted in the order his or her referral has been received.”

Walker declined to provide her foster child’s age or gender due to privacy restrictions within the foster care system, though she did say the child is insured through Medicaid.

Darwin said children on Medicaid in South Carolina tend to have long wait times before being admitted to inpatient mental health facilities because those facilities will sooner accept children with private insurance or children with Medicaid from out of state because they have higher reimbursement rates.

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While these facilities are necessary for some, Darwin says her organization typically advocates in favor of more community-based services because being closer to home can provide a more stable situation.

“The goal is to give kids the best opportunity to adapt and grow into the best person they can be,” she said.

Walker took her foster child to Conway Medical Center on March 23, and she was told standard procedure is to hold a child during a mental health crisis for 72 hours. The child was still there as of April 1.

The child first waited to see a psychiatrist electronically because Conway Medical Center doesn’t have a child psychiatrist on staff, Walker said, and the initial evaluation recommended the child be transferred to a Psychiatric Residential Treatment Facility.

The telepsychiatry consult is administered through the Department of Mental Health, and the approximate wait time is five hours, according to Director of Special Programs and Telepsychiatry Stewart Cooner.

Cooner noted that the five-hour figure is affected by factors including a patient being too intoxicated when the psychiatrist contacts the hospital, patients accumulating in the queue during non-operating hours or the number of requests for a single hospital exceeding the number of rooms equipped with the necessary technology.

Walker said she’s heard conflicting reports from hospital staff about whether a fever has kept her child from being transferred, but in the meantime, she’s been critical of the conditions the hospital has provided: a tiny, cold room in the emergency department with a concrete bench covered by a foam mattress.

She said she feels the child is being treated like a criminal — stripped of outside belongings, constantly monitored, unable to go outside or to school and unable to bring in outside food — when all they wanted was help with their mental health issue.

“It’s no wonder nobody seeks help if that’s how they’re gonna be treated,” Walker said.

Darwin, told about the conditions that Walker described, said isolating someone with a mental illness can have a negative impact.

Conway Medical Center submitted a statement to The Sun News when asked about the situation and its related policies: “Conway Medical Center evaluates each patient’s needs and if necessary works to get him or her to the proper location depending upon the diagnosis. Due to privacy and safety concerns, we cannot speak to any specific case or patient or the policies and procedures adopted involving patients.”

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Investigative project reporter David Weissman joined The Sun News after three years working at The York Dispatch in Pennsylvania, where he earned awards for his investigative reports on topics including health, business, politics and education.

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