Tuesday, April 24, 2018

After Parkland, admissions to mental health treatment centers in Florida spike

The emotional welfare of children follows predicatable patterns. In the fall, when school begins, beds at psychiatric treatment centers fill up. They empty again during summer break and the winter holidays.

In recent years, doctors and psychologists have detected a new pattern: Children’s crisis centers brim with new patients in the aftermath of a school shooting.

In the week following the Valentine’s Day shooting spree on the Parkland campus of Marjory Stoneman Douglas High, admissions of children to mental health treatment centers in Florida have spiked, professionals say.

"Children do not feel safe," said Patricia Ares-Romero, the chief medical officer of Jackson Behavioral Health Hospital in Miami. "Children are supposed to be happy — maybe a little concerned about whether they’re getting good grades, or if they are going to get grounded. Right now, they’re scared.

"Even when you have a dysfunctional family, when you do not have a good home life, there is one place where children always feel safe: in school," said Ares-Romero. "And now, that has been ripped away from them. This creates anxiety and fear, and they are coming into the hospital because they are not able to deal with that sense of uncertainty."

Jackson Memorial’s 40-bed children’s and adolescent psychiatric unit has been operating at or near capacity since the shootings, Ares-Romero said. Two-thirds of those beds typically are empty.

The lion’s share of admissions to Jackson involve middle schoolers aged 12 to 13, Ares-Romero said, and the majority of the youngsters are experiencing acute anxiety, depression and fear.

Marcia Monroe, the chief clinical officer for the Central Florida Behavioral Health Network, said the nine children’s crisis units within her authority also have seen an increase in admissions — though many of them were not voluntary.

"Given what regretfully happened in Broward, it’s not only parents and caregivers, but people’s co-workers, brothers, sisters are looking at social media — Facebook, Instagram, Snapchat — they’re looking at what’s being said, looking at photographs and taking to heart "if you see something, say something."

Martha Lenderman, a retired state mental health administrator who oversees Baker Act training statewide for USF, also said the tragedy likely prompted parents or other caregivers to seek help for their children after procrastinating in the past.

"They’ve seen behavior in the past that concerns them, but they’ve been putting it off.’’

While previous school violence has brought an uptick in admissions, the effect following the Parkland shooting has been more pronounced, experts say. The pattern has been repeated throughout Florida.

"We are certainly seeing a higher level of visits than we usually see this time of year," said Kerting Baldwin, a spokeswoman for Memorial Regional Hospital in Hollywood, which is 35 miles south and east from where Nikolas Cruz opened fire with an AR-15 assault rifle, killing 14 teens and three educators — and wounding 15 others.

Memorial’s pediatric emergency room typically sees between zero and six psychiatric patients on an average day, Baldwin said. Since the shootings on Feb. 14, such visits to the ER have about doubled, to 10 or 12.

Manny Llano, the CEO of Fort Lauderdale Hospital, said Friday he has "for sure seen an increase" in involuntary commitments for both children and adults.

"We’ve been full in the last few days," Llano said. "We’ve had to go so far as to turn them away and refer them to other facilities."

"I understand that there is lower attendance in the schools right now. People are at home, scared and concerned," Llano said. "Parents are paying attention to things they may have not before. The shooting is on their minds, and they are thinking about it and taking steps to bring it to someone’s attention."

Llano said he didn’t have data readily available but said his beds were "overflowing."

Near St. Petersburg, at the Personal Enrichment through Mental Health Services, or PEMHS, facility, the average census of the program’s crisis stabilization unit for children is about eight kids. In the shooting’s immediate aftermath, PEMHS had filled all 14 of its pediatric beds, and was sending some patients elsewhere for treatment, said Jerry Wennlund, the program’s CEO.

For budget year 2016 (the most recent data available), 32,000 children were involuntarily committed to a psychiatric facililty under what is called the Baker Act, the state’s mental health law. That represented a per capita increase of about 44 percent since 2011. Miami-Dade had the second-most such petitions, with 2,359; Hillsborough County, which includes Tampa, recorded 2,918. Broward reported an even 2,000, according to a database maintained by the University of South Florida.

Among children who are involuntarily committed, about 22 percent of the petitions are initiated at school.

On Friday, Gov. Rick Scott proposed a wide-ranging initiative to bolster security at Florida’s schools.

Read More: Here are the GOP’s responses to the Parkland massacre. Would any have worked?

The "action plan" includes $50 million in new funding for children’s mental health and a proposal to "embed" in the sheriff’s offices of all 67 counties a Department of Children & Families "crisis welfare worker for repeat cases in the community."

"We must expand mental health service teams statewide to serve youth and young adults with early or serious mental illness by providing counseling, crisis management and other critical mental health services," Scott said at a news conference.

Cruz, 19, has been charged with 17 counts of first-degree murder. His attorneys in the Broward County Public Defenders’ Office have said they would allow Cruz to plead guilty if prosecutors agree to forgo the death penalty — though such a move is seen as extremely unlikely.

Cruz arrived at the school in an Uber, wearing a dark hat and carrying a black bag that contained an AR-15 semiautomatic rifle that he had bought one year earlier from a Sunrise "tactical supply" store. He prowled the school’s interior, firing at students and teachers. Then he left on foot, blending in with panicked students. Spotted by a deputy after leaving a nearby Walmart, he was detained and cuffed.

Previous incidents of school violence also prompted an uptick in mental health admissions among children, even hundreds of miles away. Monroe, whose mental health network spans 14 counties in Central Florida, said children and youth in her catchment area sought assistance in coping with emotional trauma near the end of 2012, when 20-year-old Adam Lanza slaughtered 20 children — mostly 6- and 7-year-olds —at Sandy Hook Elementary in Newtown, Connecticut.

"After Sandy Hook there was a bit of a blip," Monroe said. "This is closer to home."

Ares-Romero, at Jackson, said Miami’s psychiatric hospital also has seen swings in admission tied to cataclysmic events such as school killings, but few had the kind of consequences as the rampage at Stoneman Douglas. "There was so much more impact, because it was so much more close to home."

At PEMHS near St. Petersburg, demand for treatment beds spiked in the immediate aftermath of the Douglas shooting, then began to decline. Many of the admissions, Wennlund said, were involuntary, and involved parents and guardians for whom the Parkland tragedy appeared to be a wake-up call.

"People were being very cautious," Wennlund said. "This has people nervous and concerned. They want to make sure that they err on the side of caution."

When a child enters the door via the Baker Act, it’s particularly traumatizing, Wennlund said. "If you have been Baker Acted, it’s not your best day. It is alarming, and scary and frightening and upsetting. And it’s not necessarily the best way to be introduced to services. But it may be the only way to get help for someone who is a danger to themselves or others."

Residents went three days without running water at unlicensed ALFs

Residents went three days without running water at unlicensed ALFs

ST. PETERSBURG — Three days.That’s how long residents of two unlicensed assisted living facilities went without running water before the authorities shut the facilities down last week.The Public Works Department said it turned off the water at 3418 a...
Updated: 7 hours ago
Exercise myths persist, so let’s fight them

Exercise myths persist, so let’s fight them

When it comes to fitness, can you tell the difference between fact and fiction? Misinformation abounds, and research is continually disproving it. Some myths, like "no pain, no gain," are fading away, but there are plenty more that persist. It’s impo...
Published: 04/24/18

Veteran who survived blast receives unusual penis transplant

WASHINGTON — A veteran who lost his genitals from a blast in Afghanistan has received the world’s most extensive penis transplant, and doctors said Monday he’s recovering well and expected to leave the hospital this week. Saying they wanted to addres...
Published: 04/23/18
Do not eat any romaine lettuce, the CDC warns

Do not eat any romaine lettuce, the CDC warns

Public health officials are now telling consumers to avoid all types of romaine lettuce because of an E. coli outbreak linked to the vegetable that has spread to at least 16 states and sickened at least 60 people, including eight inmates at an Alask...
Published: 04/20/18
Florida hits a milestone: More than 100,000 people are registered to use medical marijuana here

Florida hits a milestone: More than 100,000 people are registered to use medical marijuana here

Florida has hit a milestone of sorts as it slowly moves toward wider availability of medical marijuana.The number of patients in the state who are registered to use the substance has surpassed 100,000 for the first time, according to Florida Departme...
Published: 04/20/18
Florida Hospital Carrollwood spending $17.5 million to expand emergency department

Florida Hospital Carrollwood spending $17.5 million to expand emergency department

Florida Hospital Carrollwood is expanding its emergency department. The hospital, 7171 North Dale Mabry Highway in Tampa, is spending $17.5 million to add 15 new private treatment rooms, new pediatric rooms and waiting areas, and new technology, acco...
Published: 04/18/18
Barbara Bush’s end-of-life decision stirs debate over ‘comfort care’

Barbara Bush’s end-of-life decision stirs debate over ‘comfort care’

As she nears death at age 92, former first lady Barbara Bush’s announcement that she is seeking "comfort care" is shining a light — and stirring debate — on what it means to stop trying to fight terminal illness.Bush, the wife of former President Geo...
Published: 04/17/18
Preparing for the worst, staffers at Johns Hopkins All Children’s learn through simulation

Preparing for the worst, staffers at Johns Hopkins All Children’s learn through simulation

When the patient got violent, Dr. Michelle Hidalgo didn’t have time to think. She had to react. The woman was moving strangely and seemed erratic. Hidalgo had to make a tough call — it was time to physically restrain her for everyone’s safety.Then th...
Published: 04/16/18
Updated: 04/17/18

Lung cancer patients live longer with immune therapy

The odds of survival can greatly improve for people with the most common type of lung cancer if, along with the usual chemotherapy, they are also given a drug that activates the immune system, a major new study has shown.The findings should change me...
Published: 04/16/18
Thousands of pounds of prepackaged salad mixes may have been tainted with E. coli, officials say

Thousands of pounds of prepackaged salad mixes may have been tainted with E. coli, officials say

A Pennsylvania food manufacturer is recalling 8, 757 pounds of ready-to-eat salad products following an E. coli outbreak that has spread to several states and sickened dozens of people.Fresh food Manufacturing Co., based in Freedom, Pennsylvania, is ...
Published: 04/15/18