Tulare County hospitalizes 40 teens between September and October

Teen hospitalizations for mental health triple in September as schools in Tulare County remain closed under California’s Purple Tier

VISALIA – Mental health hospitalizations among youth are reaching alarming levels this fall. Likely as a result of the extended shelter-in-place order and distanced learning.

Health and Human Services Agency director Tim Lutz told the Tulare County Board of Supervisors that hospitalizations among teens were three times higher than normal in September. And mental health administrative professionals are seeing hospitalizations continue in October.

Youth hospitalizations

“So, we are talking about severe acute mental illness that requires hospitalization…we’ve seen that really spike in the month of September,” Lutz said during an Oct. 6 board of supervisors meeting.

According to Casey Ennis, mental health clinic administrator for the Visalia Adult Integrated Clinic, there were about 33 youth hospitalizations under a 5585—the child version of a 5150. And there have been seven in October.

The vast majority of the 40 hospitalizations over the last two months were among 11- to 18-year-olds. Thankfully they did not have a suicide and haven’t had one all year despite the affects of the pandemic. That in part is due to the diligence of her crisis response team.

Ennis has between 16 and 18 personnel who make up crisis response teams in the northern and southern portions of the county. They respond to both youth and adult crises over mental health. In September they responded to active cases such as children attempting to significantly hurt themselves. They were called out to another situation where someone was locked in a room with a handgun and refused to comply with law enforcement.

The pandemic has been an enigma on mental health. Ennis said that until recently her department was unsure how the policies during the pandemic would impact youth—along with adults for that matter—and now they are beginning to see it.

“Just in general we were waiting to see what the pandemic would do to our youth…and we hadn’t seen anything drastic until September,” Ennis said. “We are definitely concerned about what we’re seeing.”

Obviously, it is easy to point to the pandemic as the root cause. But more specific qualitative data, according to Ennis, points to experiences of significant stress from school issues due to the new distance learning format, isolation from friends and other changes at home.

Mental illness is also harder to identify because of disconnect between students and their teachers during distance learning. Teachers are sometimes the first line of defense when students are acting out and need services. By not going to school students who would otherwise stick out for behavioral issues are not noticed. Parents on the other hand are going through prolonged changes to their life as well.

“A whole lot of families have a whole lot going on. It’s just a compounding challenging issues for our kiddos out there,” Ennis said.

Even in the best of circumstances parents are not necessarily experts on mental health. Parents with children who have struggled with mental health before are more in tune to the ebbs and flows of depression and the symptoms that may develop. Ennis says that other parents are forced to turn to law enforcement when their child is acting out in a violent or dangerous way.

According to Ennis parents should be looking for signs like significant isolation, lack of participation in everyday activities and talking about hurting themselves or feelings of hopelessness. Families in the past have called her crisis response team regarding notes from youth that describe how they are going to hurt themselves. When those signs are present is when parents should be calling for help.

Chairman of the board of supervisors, Pete Vander Poel, said that he was troubled by the spike in youth hospitalizations. He added that this group is among the most vulnerable to mental illness during the pandemic because they are not lobbied for in the public sphere.

“This is everyone under the age of 18,” Vander Poel said. “We haven’t seen a single effort to try and bring the students back in the junior high to high school age and we know that’s got to be a significant portion of the population that’s probably experiencing these challenges because no one is advocating for this population sector…I’m not comfortable hearing these numbers.”

Purple tier

At last week’s board of supervisors meeting on Oct. 20 Vander Poel asked what types of resources can be offered to seventh through 12th graders. Lutz said that as long as the county is under the “Purple Tier” there is little the county can do. Some schools are operating as day camps, but that works best for smaller school districts not larger ones like Visalia Unified for example.

“The best option continues to be for us to get into the Red Tier and open up. This is a group that really is falling between the cracks here,” Lutz said. He added that school districts are working closely with the mental health branch of HHSA to stress extra outreach, support and interventions.

Vander Poel was encouraged to see an uptick in school waiver submissions around the county to reopen. Lutz said the “flood gates opened” and a lot of waivers came in earlier this month. According to him, 30 have been approved, and 53 schools are pending revisions—28 are Visalia Unified schools, 10 are Porterville Unified and the rest is a mix of public and private schools.

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