Children's hospitals in Washington state are increasingly keeping children with behavioral or psychological concerns in the emergency department for days to weeks after they're ready to be discharged because they have nowhere else to go, staff members told The Seattle Times.
These children are usually stabilized relatively quickly and do not need long-term medical or psychiatric care. However, many are often in limbo in the ED after their parents or guardian don't come to pick them up.
Family members have given various reasons for not picking up the children, according to the report. Some have said children left at the ED exhibit dangerous behaviors that put their siblings at risk. Other children may have developmental disabilities that their families do not know how to handle, according to the article.
Hospitals used to call the state's Child Protective Services to find care for children left in EDs, but the agency no longer takes custody of children abandoned in the ED, the state told Seattle Times, because the kids are considered safe in the ED.
In 2021, 11 children were abandoned at Mary Bridge Children's Hospital in Tacoma, with the average stay being three weeks. In one case, a child was stuck in the ER for 67 days.
"You wind up with, generally, three opposing forces," Chris Ladish, PhD, chief clinical officer of pediatric behavioral health at Mary Bridge, told the Seattle Times. "One is a parent saying, 'You're not hearing me, I can't [bring my child home]. You've got an ER saying the child is being completely compliant and delightful, and we feel they're ready to come home … so then what happens is you might try to get the state involved."
Hospital employees said they try to work closely with the families and state agencies to safely discharge children, but this has proven more difficult, as many social services were scaled back or cut altogether amid the pandemic.
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