Children's Minnesota served 575 kids in inpatient mental health unit's first year

Minnesota Children's Hospital - St. Paul's exterior view
The unit serves children as young as six and is one of the few in the state to admit kids with more complex medical conditions.
Elizabeth Shockman | MPR News 2022

Exactly one year ago, Children’s Minnesota opened it’s first inpatient mental health unit.

It serves children as young as six and is one of the few in the state to admit kids with more complex medical conditions — and also one of the few in the country to allow parents or guardians to say overnight with their child.

Dr. Joel Spalding is a child psychiatrist at Children’s. He joined MPR News host Cathy Wurzer.

Use the audio player above to listen to the full conversation.

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Correction (Dec. 4, 2023): The headline was corrected to reflect the number of children served.

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Audio transcript

CATHY WURZER: One year ago today, Children's Minnesota opened its first inpatient mental health unit. It serves kids as young as six and is one of the few in the state to admit kids with more complex medical conditions and also one of the few in the country to allow parents or guardians to stay overnight with their child. Joining us right now to check in one year in is Dr. Joel Spalding. He's a child psychiatrist who works in the unit. Doctor, welcome to the program. Thanks for making the time.

JOEL SPALDING: Yeah. I'm happy to be here, Cathy.

CATHY WURZER: Thank you. I appreciate that. In terms of kids, how many kids have you served in this first year? Has it been pretty busy?

JOEL SPALDING: It has. As a new operation, there's expected sort of ramping up. But we've served 660 patients this year. So it has been quite busy.

CATHY WURZER: Now, what types of conditions might you treat?

JOEL SPALDING: The most common presenting reason for admission relates to safety. The patient is unsafe because of thoughts of self-harm or thoughts of harm to others. The underlying diagnoses that are most common are depression and anxiety that end up being addressed during the inpatient stay.

CATHY WURZER: I am thinking, doctor, that when people heard me say that some of your patients are as young as six, that came as a huge surprise to them. Is it a surprise to you? I mean, what are you seeing out there? That just seems so young to be with so many mental burdens.

JOEL SPALDING: Yeah. I think we do see that. I think that in the younger ages, there's probably more anxiety than depression that presents. But that can present with a lot of agitation and a lot of aggressive behavior. That tends to be higher in the younger population. We have a child side and an adolescent side, and we opened our adolescent side first.

And that's a little larger unit because we do typically see more adolescents than younger children. But it is kind of alarming sometimes when you get into the details of patients that present and then presenting as young as they are with these kinds of concerns.

CATHY WURZER: Is there anything that has surprised you in the first year of working on this unit?

JOEL SPALDING: I wouldn't say that I've necessarily been surprised. It's been very much a learning year for our entire unit. We have some people that have had experience in other units. I think you talked about a couple of the things that make us a little bit unique. We're a child-only institution at Children's, so we aren't dealing with adults with similar [INAUDIBLE] serve a population as far as that has more medical complexity.

And we have the-- taking the approach of trying to include parents more in the patient's care while they're inpatient, including having the ability for them to stay overnight if they wish to.

CATHY WURZER: That's got to help a lot, I would think.

JOEL SPALDING: It does. It helps a lot with the engagement with the parents. Any inpatient unit has to try and address what's going on with the patient's family as a component of the care. But it really helps facilitate doing [INAUDIBLE]

CATHY WURZER: Say, help us out here, doctor. And I'm sure this is a question that many people have probably rolled around in their heads when we start talking about the mental health crisis in this country among so many children. Why are kids having these struggles? I mean, I know the pandemic is pointed at as being a catalyst. But gosh, many kids were struggling prior to that, years before the actual pandemic.

JOEL SPALDING: Yeah, we had been seeing our numbers escalate for a number of years before that. And I think there's a lot of different factors. In my mind, I think social media and the impact of social media is a big part of that. Not only does it introduce new stresses and new ways for kids to get interactions with people in negative ways [INAUDIBLE] more critically, but it also disengages a lot of young people from face-to-face social interactions, which I think are so vital for mental health as well.

CATHY WURZER: So I wonder how we-- and as a child psychologist maybe you have some ideas. How do we engage kids? What's the best way to do that? Because I think you're right. There is this level of disengagement among not only kids but adults, as I've been seeing since the pandemic, especially. But how do we start to engage kids in a healthy way?

JOEL SPALDING: Yeah, I think as a society, talking about the impact of that, I think on an individual basis [INAUDIBLE] and patients [AUDIO OUT] why they are having the problems they are. But having a frank [INAUDIBLE] spending too much time on social media impacts their mental health and helping them to understand that it's like a lot of other things. We can't get away from it. There's no avoiding it. But figuring out how to do it in moderation and how much is right for each patient. Because each patient can be a little bit different as far as the impact on them.

CATHY WURZER: I'm going to swing around and talk a little bit more here about your new unit. Still new-- it's been just there for a year. What are some success stories, understanding you can't really talk much about-- because under HIPAA. But are there some success stories that come to mind that you're especially proud of?

JOEL SPALDING: Yeah. I think that [AUDIO OUT] so we have opened some other sort of acute mental health programs. We have a partial program in [INAUDIBLE] We have a partial program that opened early this year. [INAUDIBLE] it's been a real success for us is just working on that continuum of care and working on patients being able to transition from what's usually a fairly short inpatient stay to the care that they need next.

And so that's been particularly nice to see how that works [AUDIO OUT] for hospitalization programs. But then looking at the continuum of care and how we ensure that patients get to the [AUDIO OUT] need without getting lost. Because that can be a problem as well.

CATHY WURZER: Boy, I tell you-- and I know it's not your fault, but you're really breaking up here. Your phone line is not the best, so I don't think I can go much longer here with you other than to ask, might you still expand this unit? Because it sounds like you have maybe many more children who could use your help.

JOEL SPALDING: We don't have plans to expand the unit. What we do have plans to do is expand the partial programs and expand our continuum of care in order to make sure that we have the other thing patients need when they're done with their acute care.

CATHY WURZER: All right. I really appreciate your time, doctor. Thank you so much.

JOEL SPALDING: Yeah. Thank you, Cathy.

CATHY WURZER: Dr. Joel Spalding is a child psychiatrist at Children's Minnesota. Works with the inpatient mental health unit there. By the way, if your child is experiencing a mental health emergency or at imminent risk for harm, you can call 911, of course, or go to the nearest emergency department for a mental health evaluation.

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