Mental health problems spike among NC teens

By David Larson

Raleigh, NC – Even before the COVID-19 pandemic, some parents, child psychologists, and public-health officials were drawing attention to a growing mental health crisis among American teens. But according to preliminary numbers from the N.C. Department of Health and Human Services provided to Carolina Journal in late May, this trend has only increased in the time since the pandemic, with a massive jump in suicide attempts, drug overdoses, and involuntary commitments evident among the state’s teenage population.

photo by Eric Ward

According to NCDHHS data, the number of emergency-room visits by teens for self-inflicted injuries in N.C., like attempted suicides, rose from 2,362 to 3,259 over this same period — a 38% increase. 

An increasing number of N.C. teens are also arriving at emergency rooms due to drug overdoses. In 2016, NCDHHS data showed 1.6 drug-overdose deaths per 100,000 people 13-18 years old. While this improved some before the pandemic, dropping to 1.1 deaths per 100,000, these numbers immediately spiked once the pandemic hit. By 2021, the rate was almost four-times higher, with 4.3 drug-overdose deaths per 100,000 N.C. teens. 

Drug-overdose deaths nearly quadrupled among N.C. teens during the pandemic.

These numbers may seem small when looking at the hundreds of thousands of teens in the state, but each death is a sign of thousands more in states of mental crisis and addiction. 

“Because of the pandemic and other issues, we have more and more young people that are trying to commit suicide,” state Sen. Jim Burgin, R-Harnett, told Carolina Journal. “At the point we’re at right now, especially in young people, the whole mental health aspect is very serious. Teen suicides rates are up. I’ve dealt with so many families that have had kids that have either tried to commit suicide or commited suicide. [Add] on top of that, the self medication of alcohol or other drugs. All of those things are a big concern.”

Burgin, who chairs both the N.C. Senate’s Health and Health Appropriations committees, is deeply concerned about teen mental health in the state, especially surrounding involuntary commitments and emergency room visits. 

In 2020, 2,429 N.C. teens were involuntary committed to mental health facilities, but in 2021, that number has jumped to 3,689, according to data provided to CJ by NCDHHS. This is a 52% increase in a one-year span. Burgin said a major problem caused by this trend is that so many parents are dropping their children off at emergency rooms that there is no place to send them. 

Parents are increasingly dropping teens-in-crisis off at emergency rooms. Without anywhere to send them, some get stuck at the ER for weeks.

“I had one in Harnett County that was in the hospital, in the emergency room, for 94 days, as they were waiting for a place to put that child — actually in the emergency room in Dunn, North Carolina.”

He said he’s seen the same thing repeating, including with a 9-year-old girl in foster care who had to stay in the emergency room for 29 days while they looked for somewhere to place her. 

“On any given day, there are 200 people in the emergency room for involuntary commitment; that’s children and adults, but a lot of them are children,” Burgin said. “I was at UNC the other day, and they have a whole wing up there that’s for adolescent kids that’s part of the emergency department. They have young children there, all these folks that are having issues, they end up there until they’re 18 years old.”

There are three main psychiatric hospitals in the state, with a total of 1,500 beds. And Burgin said a big issue is that around 400 of these beds are taken up by defendants in criminal trials who are waiting for competency hearings. 

“I want to move those people out, because those beds cost $1,400 a day,” Burgin said. “I want to move those people to jails or local prisons, still treat them — do the counseling, do the psychiatry — but in a less expensive environment. And then take these more severe cases and put them in a mental-health hospital.”

With involuntary commitment of teens for mental health problems “up significantly,” Burgin said he just doesn’t want them “languishing in emergency departments because we don’t have a facility to put them in.”

He plans on traveling the state with NCDHHS Secretary Kody Kinsley to bring attention to this issue and to look for solutions. 

“I’m talking to the secretary now, and we’re talking about coming up with a facility, about 100- to 110-bed facility that we can take these cases and not leave them in the emergency room,” Burgin said. “We can get them in a facility and start treating them immediately rather than letting them languish. I call it warehousing them. I don’t want to warehouse kids. I want them somewhere we can treat them and get them on the right track.”

Asked why he believes teens in modern N.C. are struggling so much with mental health, he said, “I sum it up like this: I think there’s a sense of hopelessness among a lot of young people, and it concerns me. A lot of them feel like it’s just not going to get better. I’ve talked to a lot of them, and you just see this lostness. And we as adults have got to do better. I think part of it is a lot of these devices. I think kids are having phones and being on the internet too early.”