Renovated ER rooms at Oklahoma Children's Hospital give kids in crisis a calmer, safer space
Oklahoma Children's Hospital – OU Health has overhauled three of its emergency department rooms to better serve children in crisis, outfitting the rooms with soothing, soft lighting and interactive displays for calming scenery.
The renovated rooms, which the hospital unveiled Thursday, are designed for children and adolescents experiencing a mental health crisis to have a safer, calmer space to stabilize and heal.
The rooms, called ambient experience behavioral health rooms, have arrived at a critical time: Over the past several years, more and more children and adolescents have experienced mental health crises, and the pandemic only worsened those issues.
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In a survey of Oklahoma middle and high school students from the 2019-20 school year, 9.8% had attempted suicide at least once, and more than 17% had considered suicide.
“We see at least one suicidal patient per shift at Children’s, which is astonishing,” said Erin Walker, assistant vice president of operations for the hospital.
The hospital doesn’t provide inpatient psychiatric care, but the ER is often the first place a parent may bring their child in a behavioral health crisis.
“They come here, and we try to get them to the appropriate location,” Walker said. “But while they’re here, we have to make sure that we are providing everything we can to start their journey to healing, and also do it in a safe way.”
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The environment of the ER room is important, because children may wait hours or even days there while waiting for an available psychiatric bed or appropriate outpatient care.
Dr. Robyn Cowperthwaite, a pediatric psychiatrist who leads the child and adolescent consultation services for the Children’s Hospital, said the team starts each day seeing patients in the emergency room. The past few years have been especially busy, she said.
“There have been times that mental health patients have outnumbered even our medical patients in the ER,” she said. “We always have people boarding in our emergency room for mental health purposes that we're seeking care for.”
For many of the children the team evaluates, inpatient psychiatric hospitalization would be the ideal treatment, Cowperthwaite said. But sometimes a bed is never located.
“It can be a few hours,” she said. “And then we have had such hard times finding care for children that sometimes it’s been days — five and six days, a week. Sometimes, the care has only been here, and we were never able to find anything else, and we did the best we could here in our emergency room.”
When a bed can’t be found, social workers will seek outpatient care for patients across the state, which may include partial hospitalization programs or intensive outpatient programs.
“In Oklahoma, even those programs … also have wait lists,” she said. “It’s been a really difficult time with so many of our Oklahoma children and adolescents really needing a lot of help.”
Children in other parts of the state may have an even more difficult time getting a mental health bed.
A recent research report from Healthy Minds Policy Initiative found that Oklahoma’s limited beds are mostly concentrated in the Oklahoma City metro, making up about 60% of the state’s 915 beds, however only about 36% of the state’s children live in the metro.
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Combining safety and serenity
Unlike a typical ER room where patients may share a room, separated only by a curtain, the new rooms are private and quiet.
Children can use a touchscreen board in each of the rooms to select the scenery projected on their walls — there's an array of soothing scenes available, like boats bobbing along in a harbor and even under-the-sea cartoons.
The boards can display a patient’s agenda for the day, like when they’ll bathe or go for a walk.
They also can be used for drawing, listening to music, watching TV, and playing games like Sudoku or even Whack-a-Mole. They’re designed to be durable and can withstand punching and hitting.
Medical equipment in the rooms is hidden away behind a garage-style door to prevent a patient using any equipment to harm themselves. But it can be quickly accessed by staff in an emergency.
In a typical emergency department room, there could be as many as 130 ligature points — which is anything someone could use for the purpose of hanging or strangulation — said Walker, the assistant vice president of operations with the hospital.
In the ambient behavioral health rooms, all hardware is mounted flush to the walls to reduce that risk.
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Oklahoma Children’s Hospital received funding from the federal Department of Health and Human Services and the Health Resources and Services Administration to support the new rooms.
The hospital is the first facility in the state to offer the ambient behavioral health rooms in the ER, and it's only the second in the country to do so.
Children’s Health in Dallas was the first to introduce the rooms, opening them in 2021. OU Health worked with the Dallas hospital in learning from their experience to get the rooms set up in Oklahoma City, Walker said.
“We’re hopeful that other (hospitals) decide to do it as well, because it really makes a difference,” she said.
This article originally appeared on Oklahoman: Oklahoma Children's renovated ER rooms for kids' mental health crises
