The deterioration in mental health worries adults, but also, and especially, minors. And the figures confirm it. Almost 250 children and adolescents (249) have been treated by the emergency service of the hospitalization floor of the Health Area for Children and Adolescents of the Vall d’Hebrón hospital in Barcelona since it was launched on April 12. In these three months, in addition, 41 patients have ended up admitted, the majority due to suicide attempts. The smallest patient who has gone through the emergency room was only four years old, while the average admission profile is a 14-15-year-old girl with suicidal ideation.
“This unit was a historical duty of the hospital,” explained the Minister of Health of the Generalitat, Manel Balcells, at the press conference that served to present the mental health ward. Since its launch, almost 250 children and young people have been visited in the emergency room: an average of three emergencies per day. In addition, 41 of these patients have ended up hospitalized, the vast majority due to suicide attempts or suicidal ideation, although there have also been cases of patients with anorexia nervosa or psychotic episodes, explained the head of the psychiatry service, Dr. Josep Antoni Ramos- Quiroga.
Although the youngest patient seen in the emergency department was only four years old, the average profile of the patient is a 14-15-year-old girl with suicidal ideation. Ramos-Quiroga has explained that any mental disorder that has a severity “that does not allow community management”, such as suicidal ideation, behavioral disorders or some Eating Disorders may end up requiring admission, whose average hospitalization is in the 10 days. However, there are patients who need more or less. This is the case of Claudia, 17, who became the first patient on the floor in April. This young woman, present at the presentation of the service, remained hospitalized for a month.
“Most of the cases that we deal with are self-injurious behaviors or suicide attempts”, explained Dr. Marc Ferrer, Head of Hospitalization at the psychiatry service. Ferrer has assured that these behaviors are “on the rise and a response must be given”, but they were already seen before the pandemic. Thus, if in 2015 and 2017 self-harm represented 20.4% of admissions to psychiatric emergencies, now it is already 75%. Despite this, the psychiatrist has explained that more than one planned suicide idea is often an “impulsive and uncalculated behavior that seeks disconnection.”
Sometimes admission is ordered not so much because of the seriousness of the situation but because it is considered that “adequate containment” cannot be carried out from home, explained Ramos-Quiroga, who has pointed out that despite the fact that fewer admissions are produced in summer , they estimate that by the end of the year the unit will have hospitalized close to 180 patients.
The opening of this service along with others such as Can Ruti have led to the disappearance of waiting lists for admissions in acute cases, Ramos-Quiroga has assured. The unit has eight beds for a population of 80,000 children and young people from Nou Barris, Sant Andreu and Horta-Guinardó “12 of the 18 neighborhoods with the most disadvantaged socioeconomic indicators”, Balcells pointed out.
The hospitalization floor is a multidisciplinary service that has two psychiatrists, two clinical psychologists, nurses, a social worker, an occupational therapist or a teacher who is in permanent contact with the educational centers that the patients attend. The idea, remarked Marc Ferrer, is to prioritize community work, but psychopathological problems sometimes require hospitalization “due to severity or to carry out a specific treatment.” Therefore, the idea and the desire is that they are stays as short as possible.
The unit is located on the third floor of the children’s hospital and has been designed with the collaboration of patients. It has a virtual reality projector to do therapy in a playful way in which, for example, the patient can feel like they are swimming in the ocean with dolphins. It has the so-called Espai Blau (blue space), used to “deactivate” the patient’s condition, in addition to favoring the reduction of stimuli, explained the supervisor Merche Rodríguez. The idea is to do therapy in a playful way.
In addition to self-injurious behaviors, addictions to social networks or eating disorders, the unit has also treated autism spectrum disorders as well as some psychotic disorders.
