Cape Fear Valley officials hopeful new unit will help address youth mental health crisis

Fayetteville mental health professionals hope a new inpatient unit at Cape Fear Valley Medical Center will help adolescents who face issues made worse by the COVID-19 pandemic.

Dr. Sree Jadapalle, a child and adolescent psychiatrist at Cape Fear Valley Medical Center, said the demand for child and adolescent mental health care has been exacerbated since the start of the pandemic.

Before the pandemic, she said she saw about five children a week, but she now treats anywhere from five to 15 children a day.

In October, a national state of emergency in children’s mental health was issued by the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association.

Two months later, the U.S. surgeon general issued an advisory on the mental health crisis.

Dorothea Dix Adolescent Care opens

In March, a new inpatient mental health crisis unit for children ages 13-17, called Dorothea Dix Adolescent Care, was added to the campus of Cape Fear Valley Medical Center. The addition of the 16-bed facility cost the medical center about $4 million, Jadapalle said, and was funded by the state.

John Bigger, the director of behavioral health and sleep medicine for Cape Fear Valley Medical Center, said that before Dorothea Dix Adolescent Care opened, the nearest inpatient facility was nearly 75 miles away.

Bigger said prior to the pandemic, Cumberland County was in need of an adolescent inpatient unit.

“Then when you add in the pandemic, it created a tremendous challenge,” he said. “Adolescence is that crucial period when you are determining your identity.”

Bigger said when the pandemic hit, many children were stuck at home, unable to socialize or get out of the house, which contributed to the mental health crisis.

A lot of children were struggling trying to figure out how to function in a society that was limiting their ability to socialize, he said.

Bigger said a team of mental health professionals at the clinic helps adolescent patients focus on themselves during their stay. Children may end up in the inpatient unit for a few reasons, he said.

Treatment

The criteria for being admitted to the inpatient unit is self-harm and/or thoughts to harm others, Bigger said.

“The No.1 diagnosis is going to be major depression and mood disorders,” he said.

Depression can be caused by various things, such as a genetic disorder or past traumas, Bigger said.

When a child suffers, the whole family suffers, Jadapalle said.

One symptom of anxiety or depression in children and adolescents is when they stop being able to participate in everyday activities, such as going to school, Jadapalle said.

Traumatic events such as death, bullying, domestic abuse, and/or sexual assault can all cause mental health issues, she said.

The inpatient unit, staffed by psychiatrists, psychotherapists and recreational therapists, helps children develop through positive self-affirmation, therapy and/or medication, if necessary, Bigger said.

On average, there are five children and 10 employees on-site at any given time, he said.

The adolescent unit can house 16 patients at a time, he said. Before the new unit was completed, patients under the age of 18 would be housed inside the hospital during a mental health crisis situation.

Meeting demand

Jadapalle said mental health care can be expensive, but that Cape Fear Valley Medical Center will serve families without insurance through Alliance Health.

Alliance Health is an organization that assists residents of Cumberland, Durham, Johnston, Mecklenburg, Orange and Wake counties who are insured by Medicaid or are uninsured with treatment or support for mental illness, substance abuse, and mental disabilities.

As a way to meet the demand for child psychiatrists, Jadapalle said the medical center has sponsored a new fellowship. The new fellowship is dedicated to training more child psychiatrists, she said. Currently, there are five child psychiatrists at the medical center, she said.

“We work with families, we learn to work with school systems, we learn to work with … DSS, so there’s a lot of specialty training that … you do not get as an adult psychiatrist,” she said.

In order to become a licensed child psychiatrist, an additional two to three years of practice is required, she said.

In addition, the medical center started a child and adolescent residency clinic, which is an outpatient program, for children awaiting regular outpatient treatment, said Bigger.

Nearly 350 children and adolescents have been treated for mental health issues this year, she said.

Jadapalle said it's important for parents to get their children treatment for mental health issues.

“We are failing them by not getting them the help that they need,” she said.

Health and education writer Ariana-Jasmine Castrellon can be reached at acastrellon@gannett.com or 910-486-3561.

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This article originally appeared on The Fayetteville Observer: Cape Fear Valley Medical Center Dorothea Dix Adolescent Care Unit