I lived through a nightmare at the U-M Psychiatric Emergency Room. The pandemic made it worse, but didn’t cause it. It happens to families there all the time.

My twelve-year-old son is aggressive. We’re not sure if it’s because he has a rare form of epilepsy, or because of the medications he takes to control it, but in October he was attacking family members ten to twenty times a day. So I brought him to the psych ER and asked for him to be admitted for help getting his behavior under control.

They took my son to a room in back and told me to wait in the waiting room. Parents could not visit their children, I was told, to protect the privacy of the other patients. But as long as he was in the ER, I was still legally responsible for him–so I couldn’t leave the hospital building for more than two hours at a time.

I spent the next five days and nights waiting at the hospital. The psych ER’s waiting room was usually too crowded to do social distancing, the soap dispenser had been removed from the bathroom, and sleep was nearly impossible.

A hospital social worker told me that other people could sleep in the waiting room and I could do it, too. But I’ve never been able to sleep in public places–not in planes, on buses, or in waiting rooms.

Since I wasn’t allowed to see my son and I am easy to reach, each night I would slip out of the waiting room, go home, and try to sleep in my own bed. And every night, at two or three in the morning, I would get a phone call demanding that I return to the waiting room. If I didn’t come back right away, they said, they would call Child Protective Services.

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I never got more than about three hours of sleep a night while my son was in the psych ER. Once, when I came back after being called, I tried sitting near the hospital’s front desk, where the staff had told me that it would be easier to sleep. But it wasn’t. The room was fully lit, people were talking, and at 4 a.m. a loud floor-washing Zamboni drove through.

I don’t think anybody ever intended for patients to spend five days in the psych ER waiting room. But, while the doctors agreed that my son needed to be hospitalized, no beds were available anyplace in the state.

This was not due to Covid. Long before the pandemic, Michigan had far more psychiatric patients who needed to be hospitalized than places to treat them, resulting in long waits for care.

According to an Mlive.com article last year, since the early 1990s the number of psychiatric beds in Michigan has fallen by more than half, to just 3,200. The head of the state’s largest private provider explained that insurance pays a third as much for psychiatric hospitalization as it does for medical care, making it a “black hole into which you dump money.”

The U-M has just three psychiatric beds for complicated adolescents like my son, and they were full. The most likely alternatives were located up to an hour away, and they were full, too. I was told that if a bed did become available there, my son would be transported in an ambulance, but I would need to follow in my car, check him into the new institution, and then drive another hour back home again–all while sleep-deprived.

Between the risks of Covid infection and falling asleep at the wheel, it felt like the rules were designed to kill parents, several times over.

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Eventually, a space opened up in a U-M psychiatric ward and my son was admitted–he did not end up an hour away, after all. Once he was hospitalized, other patients’ privacy was no longer an issue: I was able to visit him–and to sleep at home at night.

There is nothing unusual about the hurdles we jumped to get him there. Other parents have told me that they, too, have waited days before their child was admitted.

Unfortunately, not all families have the resources to do that. If family members cannot take time off work–or have other children at home, or have medical problems of their own–that child may never get care.

I know, because this was not the first time I’d tried to have my son admitted. The last time, several years ago, my other children were too young to be left alone at home. Unable to wait for a week in the ER, I gave up and brought my son home without getting the help that he needed. We continued to live with his violence for years.

Having to spend days in the waiting room is one way to limit the demand for psychiatric hospitalization. But it doesn’t give priority to the children who need help the most–it gives priority to those whose parents are able to rearrange their lives to have someone on hand 24/7. This is not a reasonable way to ration health care!

Once he was admitted, my son was hospitalized for two weeks. They changed his medication, and for the moment his aggressive behavior is much less frequent. But he acclimates to some medications and they stop working, and he has had life-threatening reactions to others, so the current peace is not likely to last.

I worry that someday we will need to go back to the psych ER. And I dread that.

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I filed a complaint with the hospital. My son’s pediatrician also tried to get them to change their policies, so far without success. I wrote this article because I hope public attention will help.

Nobody should have to camp out for days to get a child the care they need. Parents need to be able to eat and sleep so that they can support their children.

The hospital needs a fairer way to ration psychiatric care–one that doesn’t limit it to families that are privileged enough to be able to take extended time off. And the state needs more psychiatric facilities, so that in the future parents won’t have to spend days and nights in waiting rooms, trying to sleep in chairs.

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from Calls & Letters, February 2021

To the Observer:

Your January article about the U-M Psych Emergency covered the patient’s side of the situation well, but did you interview the nurses involved? These patient people often go home battered both mentally and, yes, physically, too. In this case (and others) there are details left dangling that would more accurately characterize an essential clinic.

As for finding ideal spots to place less than ideal patients, it’s well-know that with the closing of the once-busy Ypsi State, Eloise, and others, the task must be incredible.

Sincerely,
Alice Bingner