Adolescent mental health care needs in North Alabama far exceed available space

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DECATUR, Ala. — The mass school shooting in Florida has again put the spotlight on the U.S. mental health care system and in North Alabama, there is far more demand for inpatient bed space for adolescent patients than available beds.

Decatur Morgan West Hospital provides the only in-patient care for kids and adults between Nashville and Birmingham.

Amy Gillott, director of the Decatur Morgan West Hospital, said the facility’s adolescent unit stays full. And they see plenty of young people who are hurting.

“More often than not they come through an emergency room. Because they are suicidal, or the parent or the guardian does not know how to handle their behavior,” Gillott said.

They provide a range of services, but the needs exceed their capacity.

“For adolescents, we offer 18 beds,” Gillott said.

She said the bed space isn’t adequate.

“We often have two to three adolescents that are waiting in an ER somewhere, waiting on a bed to come available.”

Gillott says the kids they’re seeing often know they need help and most wind up there voluntarily. In rare cases, a teen will be committed on the order of two doctors.

“A lot of them have depression and suicidal thoughts, they may want to harm others. And it’s not unusual that they have a mixture of all of that,” Gillott said.

Gillott said troubled adolescents will self-medicate through drug use, alcohol or self-mutilating. She encourages taking seriously signs of an adolescent’s struggles

“Don’t ever sit and think that the symptoms are going to go away. If it’s bad enough to get someone’s attention, it’s bad enough probably that it needs some further education, training and experienced person to work with their problems,” Gillott said.

Gillott said the Decatur Morgan West Hospital serves all of North Alabama and beyond.

“We are located between Vanderbilt Hospital and Birmingham UAB, so we serve all of the middle areas there and it is not unusual that we get a kid that is transferred here from even Dothan or as far as Tennessee,” she said.

There used to be more private beds and a state-run facility, but that changed and things got worse for a lot of people, she said.

“In 2015 APS closed its doors, which was on outpatient psychiatric treatment, and right following that, the state closed North Alabama Regional,” Gillott said. “And as soon as both of those were shut down it left thousands of people without treatment. And thousands of people went long periods of time without medication management. Or outpatient treatment.”

Even if a patient gains access to in-patient care, it may be short-lived

“A patient can come in here very sick, and if they have commercial insurance, it is difficult for us to get approval for many days in the hospital,” Gillott said. “So they have to get well quickly, and often times in mental illness that is not the case. It can take a lengthy process to get them well, or to get them stable to go out and be discharged back into the community.

Little state funding and less private care means that for many mentally ill people in North Alabama, “It is right to say they don’t have anywhere to go,” Gillott said.

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