When the COVID-19 pandemic pushed schools to around the country to cancel in-person classes, Emma Warford was 15 years old, an active athlete, a good student and functioning well. However, as days …
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Amid calls for more funding and services to help address the growing mental heath crisis in America’s youth and teenagers, officials at Children’s Hospital Colorado say progress was made in 2022.
While dealing with the crisis is going to be a marathon to develop effective change to an outdated system, Zach Zaslow, director of government relations at Children’s Hospital Colorado, said the Colorado General Assembly and lawmakers in Washington are starting to listen.
At the state level, Zaslow said, Colorado earmarked $450 million of American Rescue Plan Act funding.
“This is a big step because we have to make sure children and youth are getting their fair share,” he said. “Some of these funds will go to schools, improving the workforce, therapy and foster care.”
At the national level, Zaslow said, some laws being introduced can make a big impact on helping an overwhelmed system that only got worse after the COVID pandemic started in 2020.
A bill Zaslow said shows promise is Senate Bill 4472, the Health Care Capacity for Pediatric Mental Health Act, introduced by Sens. Bob Casey, a Democrat from Pennsylvania, and Bill Cassidy, a Republican from Louisiana.
According to the Centers for Disease Control and Prevention, or CDC, 1 in 5 children and adolescents experience mental health issues each year. Between the years 2016 and 2020, emergency room visits for children’s mental health more than doubled in the U.S.
Senate Bill 4472 looks to address the struggling system by including critical investments that will bolster the pediatric mental health workforce and improve the availability of a full continuum care for kids.
Zaslow said the bill will go a long way in helping improve capacity issues and mental health facilities.
In Colorado, Zaslow described a system that is at capacity in its ability to treat youth and teenagers dealing with mental illness.
For example, 17-year-old Emma Warford was diagnosed with an eating disorder in 2021. With her condition at critical levels, doctors recommended she be admitted to a clinic that specializes in treating eating disorders.
Colorado’s centers were full. Warford was sent to Washington state to get critical treatment.
Zaslow said with the health care system lagging in properly recognizing and treating mental health, youth like Warford either have to be sent out of state or never get treatment at all.
The House, HR 7236 aims to expand availability of mental, emotional and behavioral health services under the Medicaid program.
While in its early stages, Zaslow said, this bill also shows promise.
When the COVID-19 pandemic pushed schools to around the country to cancel in-person classes, Emma Warford was 15 years old, an active athlete, a good student and functioning well.
However, as days turned to weeks and weeks to months, Warford said she began worrying about her weight while sitting at home in quarantine. The then-sophomore started counting calories, admitting she became obsessed with her food intake.
Even after school returned to in-class learning, Warford said she continued to latch onto her calorie-counting habit, calling it her “coping mechanism” for stress.
In 2021, Warford, who lives in both Highlands Ranch and Centennial, said she went to see her regular-care physician who took notice of her weight loss.
“My doctor noticed that I had completely fallen off my growth chart,” the now 17-year-old said. “They tried to get me some therapy and a nutritionist to work with.”
When asked how much weight she lost, a choked-up Warford said more than 40 pounds.
Warford was diagnosed with anorexia nervosa, an eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight. According to the Centers for Diseases Control and Prevention, or CDC, an anorexic teen will skip meals, eat small portions, become obsessed with counting calories, or, in some cases, starve themselves.
During the pandemic, health organizations across the U.S. sounded the alarm in rising cases of youth and teens being admitted into emergency rooms with mental health issues, including eating disorders.
According to a CDC report, between 2020 and 2021, emergency room visits for teens with mental health issues increased by 24%. The CDC reported that female teens between the ages of 12 and 17 were primarily seen in emergency rooms due to complications caused by an eating disorder.
Zach Zaslow, the Children’s Hospital Colorado director of government relations, said mental health and eating disorder cases for youth and teens were already on the rise in the United States. When the pandemic hit in 2020, it exacerbated the issues to crisis levels.
In 2021, after the general therapy and working with a nutritionist did not work, Warford’s condition became worse, leading her to a visit at Children’s Hospital Colorado where her heart rate was around 29.
The normal heart rate for a teenager is between 60 and 100 beats per minute.
Children’s Hospital doctors said outpatient treatment was not going to help Warford get better, telling her mother, Christine Hendrickson, that she needed to be admitted to a facility that specializes in treating adolescents with anorexia.
An overwhelmed system
Once doctors emphasized that Warford needed extensive treatment, Hendrickson said the real struggle began. With her daughter sick, Hendrickson described a medical care system that diagnosed her daughter but then left her in the wind trying to figure out what to do.
In Colorado, mental health has reached crisis levels, causing care facilities to be full and parents and families struggling to find a place to seek treatment for their youth and teens.
Hendrickson said when she was told the eating disorder clinic in Colorado was full, she started calling other states, getting on waitlists, trying to use the internet to educate herself and trying to understand a system where her daughter was not getting the help she needed.
Eventually, Hendrickson found her daughter a spot at a facility in Washington. With no other choice, Hendrickson said Warford needed immediate treatment and they had no other choice except to send her out of state.
Hendrickson said the decision was tough but had to be done. She said her employer was understanding and worked with her in taking time off.
“It was really a huge struggle to balance it all,” the mother of three said. “You know as a parent you are making mistakes and will continue to make mistakes. There really are no resources or advocacy for families like us. You are left dealing with a system you do not know all on your own. It was hard to get clear information. You are really on your own and you are lost.”
Zaslow said Hendrickson is not alone.
“COVID turned on eating disorders, but kids and families were being told to turn off mental health,” he said. “We (as a system) have to really look at how we do things. The challenges (Hendrickson) has had to go through with care navigation and work on her own should not happen. If we had a cohesive system to help with mental health, families wouldn’t be out there doing this alone.”
Hendrickson said it was hard to drive her teenage daughter up to a strange facility in another state and leave her, but she knew it was the right choice.
Today, now recovering, Warford said treatment was hard but knows there is no way she could have overcome her worst days at home with her mom.
“If my mom had made me do the things they did, it would have ruined our relationship,” Warford said. “There was nothing my family members or a therapist could do for me then. Now I am physically better, but I still have an eating disorder. Treatment was what I needed.”
Pushing for change
As Warford has returned to a routine life and sticks to her treatment plan to avoid a relapse, she has teamed up with children’s hospital to do more.
Warford, who will be a senior in high school this fall, is now taking aim at state and federal lawmakers. The teenager said her goal is to put a face to the struggles this country is facing in helping young people dealing with mental illness.
In June, Warford, along with officials from Children’s Hospital Colorado, took their cause to Washington, speaking directly with lawmakers from Colorado and all over the U.S. about what her family dealt with in trying to get her treatment.
Hendrickson said in speaking to the public and to lawmakers, she wants to stress that in this country, “just because someone looks good on the outside – we do not know what is going on on the inside. We need compassion and help.”
Zaslow said the courage Warford has shown in standing up and putting a face to not only eating disorder awareness, but also to show lawmakers that real people are hurt by an outdated system, is impressive.
“She is part of important, meaningful steps to create change,” he said. “(Lawmakers) want to do the right thing but get confused and bogged down in legislative text. Having a real human being say this is the state of my world is huge. They too have children.”
With Children’s Hospital Colorado pushing for change at the state level and the Children’s Hospital Association pushing at the federal level, Zaslow said he believes change is starting to take shape nationwide.
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