The US Surgeon General described it as an “urgent public health crisis” - a devastating deterioration in the mental health of children across the country. According to the Centers for Disease Control and Prevention, rates of suicide, self-harm, anxiety and depression are rising among teens — a trend that began before the pandemic.
Tonight, we’ll take you to Milwaukee, Wisconsin, a community trying to help its children overcome a mental health crisis. As we first reported in May, Wisconsin has the fifth highest increase in teen self-harm and attempted suicide
in the country, where rates have nearly doubled since before the pandemic.
In the emergency room at Children’s Hospital in Milwaukee, doctors like Michelle Beckett see more and more children desperate for mental health help.
Dr. Michelle Beckett: Unfortunately, we see many children who have attempted suicide. This is something we see I will say at least once turned.
Shareen Alfonsi: Once turned?
Dr. Michelle Beckett: Oh - yes. Unfortunately yes.
Dr. Beckett worked in the emergency room for 9 years.
SHARIN ALPHONSI: Is there any group that hasn’t been affected?
Dr. Michelle Beckett: No, we see everything. children, as you know, who belong to well-off families; children who do not do this; Children in the suburbs. Urban children Rural children. We - we see everything.
The increase in families needing help for their children revealed a shortage of people and places to treat.
Across the country, the average wait time for an appointment with a therapist is 48 days — often longer for children.
Sharine Alphonsi: What does he tell you that the place they should come to is the emergency room?
Dr. Michelle Beckett: There is something wrong with our system. The emergency room shouldn’t be the place to go and get acute mental health care when you’re in a crisis. We are not a nice and quiet environment.
SHAREN ALPHONSI: But they are desperate -
Dr. Michelle Beckett: Yeah, we’re there and we see everyone. But I wish there were more places for kids to go to get the help they need.
To manage the mental health crisis and heavy caseload, Dr. Beckett provided an iPad with a series of questions examining the mental health of every child ten years of age or older who comes to the emergency room for any reason.
Among the questions: “Have you thought about killing yourself” and “Did you feel that your family would be better off if you were dead?”
Tough questions that can be a lifesaver for the kids who answer them.
Dr. Michelle Beckett: We had four kids that I know personally who had a completely unrelated problem, like a broken arm or an earache or whatever it was, and they were actually so suicidal that we needed to take them inpatient - facility right then and there. So, we’re picking up kids, you know, who are going through such a big crisis. But we also pick up kids who just need help and don’t know what to do, and we haven’t really talked about this.
According to the Centers for Disease Control and Prevention, hospital admissions data shows that the number of teenage girls who have committed suicide has increased by 50% nationwide since 2019. Sofia Jimenez was one of them.
Sofia Jimenez: I remember crying every night not knowing what was happening and feeling lonely.
Sophia and her friend, Nina Hughes, were in eighth grade and looking forward to high school when COVID turned their world upside down.
Nina Hughes: I’ve always been a very smart kid, and I always got really good grades. And then once the pandemic hit, I failed to class. When I was hypothetical I had no motivation to do anything. I’d just sit in my room, never leave, and it was, like, obvious signs of depression.
Sofia Jimenez: My mental health has gotten really bad, especially my eating disorder. I was home alone all day. My parents - well, they noticed I don’t eat. I refuse to eat. Then they ended up taking me to the hospital.
Sophia had to stay in the hospital for two weeks before opening a bed in a psychiatric facility.
Sharine Alphonsi: Your generation, like, got hit by this in what’s supposed to be a fun and carefree time. What did he lose? What have you guys lost during the pandemic?
Sofia Jimenez: Myself.
SHARIN ALPHONSI: You are yourself.
Nina Hughes: Yes. I would definitely say there were huge parts of myself - I definitely lost. I lost friends because we won’t see each other. We couldn’t go home for the first time, and I couldn’t have graduated from eighth grade. I know this doesn’t seem like a big deal, but we were looking forward….
Sharyn Alphonsi: But it’s a big deal when you’re in the eighth grade.
Nina Hughes: Yes. I feel that if the epidemic never happened, a lot of my problems like grief and mental problems wouldn’t be as bad as they are. It made everything worse.
Shareen Alphonsi: Are we in a crisis now?
Tami Makhlouf: We are. We are in crisis mode. That’s scary.
Tammy Makhlouf has worked as a pediatric therapist throughout Wisconsin for the past 25 years.
Sharyn Alphonsi: I think there was hope that we’d go back to school, that the kids would be able to see their friends again, and play sports, until all of this was gone. he got it?
Tami Makhlouf: No. no. I’ve noticed waiting lists are longer, kids have more anxiety and depression. So we were in a mental health crisis before the pandemic.
SHAREN ALPHONSI: Has the epidemic accelerated its occurrence?
Tami Makhlouf: I think so. We’re out of the pandemic, but kids still lose two years. Two years of socialization, two years of education, two years of their world kind of fluctuates. So when we get the unquoted quote, “Back to normal,” I think the kids are struggling. Even when the pandemic ends, this crisis will not.
CDC figures show that even before the pandemic, the number of teens who said they felt persistent sadness or hopelessness had risen 40% since 2009.
There are plenty of theories as to why — social media, increased screen time and isolation, but the research isn’t definitive.
Last March, Children’s Hospital selected Tami Makhlouf to operate an urgent care clinic that was opened specifically to treat children’s mental health.
Open seven days a week from 3 to 9:30, it is one of the first clinics of its kind in the country.
Tammy Makhlouf: So when they come to our clinic, we evaluate them and give them a treatment session. So we give them some interventions and we give them a plan and a plan of action.
Plans are catered for each child’s condition. Actionable things families and children can do as they search for a doctor or facility to make room for them.
Shareen Alphonsi: How long have the queues taken to get help?
Tami Makhlouf: Usually you get an appointment within a few months.
Charin Alphonsi: Months?
Tami Makhlouf: Yes. And then, if you want a child psychiatrist, you’re looking at months to a year.
Sharyn Alphonsi: How important is it to help them right away when they need it?
Tami Makhlouf: As the days go by, the symptoms get worse. If you have a depressed child, you know, they probably started in terms of feeling depressed, and then as the days go by, they have suicidal tendencies. So really — you really need to get that help and that support right away.
Eleven-year-old Austin Bruinger desperately needed this support during the pandemic. He’s a fifth grader at Roosevelt Elementary School in Milwaukee.
Sharine Alphonsi: How old were you when the epidemic struck?
Austin Brueninger: I was nine years old. I was still going to school, but then I kept hearing the news in the car, just like a pandemic, stay in quarantine, 14 days.
Sharine Alphonsi: When they first said, “Hey, I don’t have to go to school,” what was your reaction at that moment?
Austin Bruenger: Heaven. But then I realized it was just the opposite.
On the contrary because like millions of school-age children, Austin has been forced into distance learning for over a year and has broken up with friends.
Austin Brueninger: I was like this closed off. The only way you can see people is through like, phones or your family you live with.
This isolation affected Austin who was already reeling from the news that his parents were getting a divorce.
Melissa Bruinger: And that’s when I think it all just started getting inflated. He, you know, was always asking to see his friends. we could not. And I remember there was one moment he was on the ground, like kicking and punching in the air. Only - but he couldn’t describe why he was upset.
Unable to vent with friends, and without access to personal therapy, Melissa, Austin’s mother, says his world is starting to get closer.
Melissa Bruinger: I felt like he was less reactive and kind of withdrawn into himself and spending a lot of time on his own. And I went to enter him and he said to me, “Mom, I have suicidal thoughts.”
SHAREN ALPHONSI: And how old was he?
Melissa Bruinger: He was nine years old. And like, I was kind of like, I didn’t know what to say. I didn’t know what to do.
Austin Brueninger: I’ve pictured myself going through all these things like jumping off a building and taking a knife out of my kitchen and ending my life. More than 50 of them were the ones who just flooded my mind. I don’t really know if it was caused by all of, like, antisocial and powerlessness - I also felt that with the divorce came a lot of yelling and I felt like my dad didn’t need me anymore. It’s really hard to think about at that moment.
Desperate, Melissa called her pediatrician in Austin who referred her to outpatient therapists and inpatient psychiatry programs—only to be told there were long waiting lists and no beds.
Melissa Bruenger: All this stuff is racing in my head. Then to say, “Well, no family at the moment.” And I’m like, “How am I going to keep it safe?”
In an effort to try to keep children safe, Wisconsin is trying another approach that is being adopted in other parts of the country.
Seventeen pediatric clinics across southeastern Wisconsin have integrated full-time therapists within their offices. Provide mental health examinations and treatments as part of routine care. Dr. Brilliant Namer was the first pediatrician in Milwaukee to establish a therapist’s office within her office.
Sharine Alphonsi: You’re saying, “We’re here together, we’re all going to work on this together,” not “We can’t help you, go see someone else.”
Dr.. Brilliant Namer: Exactly. Thus, having a therapist in our clinic really has - teaming up to discuss that patient and family together, to bounce ideas off of each other, ‘because we know them so well -‘ is so much better for the patient to take care of.
Dr. Nimr’s clinic treats an underserved community where families often struggle to get mental health help. The therapists here have treated more than 500 children since the epidemic began.
Dr.. Brilliant Niemer: I think we as pediatricians and primary care providers can no longer just say, you know, ‘Mental health providers, you’re the only ones who are going to care about our patients in terms of mental health.’ This is now something we need to do as well.
Pediatrician in Austin Brueninger now has a therapist in her office, too. Their family was fortunate to find regular depressive treatment on an outpatient basis.
Shareen Alphonsi: How do you feel now?
Austin Brueninger: I don’t know. It’s much better than before. Everything happens in my life, knowing that I’m, like, friends with everyone in my class, building a better social life, like. It is interesting to know that there are others who love the same things as me.
Sharyn Alphonsi: Austin, it’s not easy to talk about all of these things. Why did you agree to tell us what you’ve been through-
Austin Brueninger: Because the world needs this, the world needs to know that. Mental health and things like that need to be addressed, otherwise bad things could happen. If you’re doing this on your own, try calling someone you know, like your friend and family.
SHAREN ALPHONSI: And talk about it.
Austin Brueninger: Yes.
Produced by Ashley Willy. Co-producer, Jennifer Dozor. Broadcasting Assistant, Elizabeth Germeno. Edited by April Wilson.