I recently spent the better part of a Sunday in the Emergency Room in a renowned Boston hospital after my daughter crashed into a tree while biking. She received excellent care and has recovered remarkably well. We were incredibly lucky that the injuries were mostly cosmetic and she did not sustain more significant bodily trauma. But sadly, if her injuries had been of a more psychological nature, I think the outcome would have been far different.

On that Sunday in early May, we were in and out of the emergency room in a mere eight hours. At the scene of the accident, she received emergency EMT triage and once at the hospital we received immediate and comprehensive care. My daughter was screened for every possible physical injury and when the biggest concern turned out to be in her mouth, the on-call dental physician drove into the hospital to perform the procedure. And still we were in and out in eight hours. We left the emergency room with very clear discharge instructions. The next day we went in to see the pediatrician, and a few days later the dentist. A few weeks after that, we consulted with a plastic surgeon. I am so grateful for the helmet, the excellent care, and our health insurance. Thankfully she has mostly healed and this will be a funny story she tells of the time when a tree crashed into her and she walked away with nothing broken. 

The young person across the hall from us is not so lucky. They were lying on a hospital bed in a small dark room and I noticed them watching us, which wasn’t so notable because there was lots of activity in our room. But it became clear that no was going in or out of the room, the youth received essentially no care in the many hours we were across the hall. A hospital worker sat in the door, with a badge hanging from the chair, but did not interact with the teen in the bed. I started to wonder about this young person’s story, and if they would be ok. Then I noticed several other rooms with “sitters” in the doorway. And then it all clicked into place, what I have been hearing about from my colleagues and patients about the abysmal state of our mental health care system. 

Unlike my daughter, this young person (among many others) was in the emergency room for psychological trauma. I don’t know how long they had been there, or how long it took them to get the treatment that they will need. I don’t know if the hospital was able to find a spot at a mental health treatment facility or an outpatient provider that had the capacity to see this young person or if any of that care, even if it was available, would be covered by insurance. And the room across from us was just one of many in a crowded Boston emergency room on that one night.

I am a psychologist and I have been writing about the importance of mental health and mental health care for the last 3 years. We have all been hearing about the mental health crisis and the rising rates of anxiety, depression, suicide, and eating disorders in our youth.  What I learned about mental health care from a bike accident is really not new to me, but never has it been so clear as that night in the emergency room. Our system is built to triage, assess and treat physical illness and bodily injuries (provided of course that you have access to health insurance, the means to navigate the health system and financial resources to pay). Sadly, if your illness is brain-based, your path to wellness will be much more convoluted and not at all guaranteed. And that path to securing mental health services for yourself or a loved one, especially a child or adolescent, will require an enormous amount of energy, patience, determination and sheer grit.

I believe we need to do better for the young people in our lives. Our system needs reform, if not reconstruction, in a way that addresses mental health as equal to physical health. This means treatment must be available, accessible, robust and covered by insurance. The mental health of our future depends on it.