ATLANTA — Emergency rooms aren’t built for long-term care. That’s why Maria Manning is so confused her son was kept in the ER at Northside Hospital in Lawrenceville for two months.
“That’s equivalent to just being in the airport trying to get on an airplane for two months,” Manning said.
Jaylen sat in limbo because he didn’t need surgery. He needed mental health care. But Jaylen is an adult with autism and is developmentally disabled. Right now, the state only has the specialized staff to care for about 35 people like him in crisis.
Georgia actually has funding to support 52 crisis beds for those with developmental disabilities and complex needs, but providers that manage seven of those slots can’t take people right now because they don’t have enough staff. Another eight of those beds aren’t available because the staff has been re-directed to help existing patients with more intensive needs. It’s a shell game based on need and staffing each day.
Still, after a dangerous and destructive breakdown last November, Manning realized they were literally – and figuratively – trapped.
“He completely ripped the banisters off,” she said showing 11Alive Investigator Rebecca Lindstrom where the hallway in her townhouse was blocked by broken glass and debris. “Everything was here. Glass, like in this space. The banister pieces, the big mirror, the broken glass. There was stuff that fell off the wall.”
Paramedics eventually had to sedate Jaylen to get him to the hospital.
“They were trying to get him to lay down on the gurney, he won’t do that. But at the same time, he’s going without me and he’s just looking at me, like, 'what’s going on?'" she said. "I’m just looking at him, he’s looking at me and it’s like – I felt so helpless but I felt I didn’t have a choice.”
Manning knew at that moment her son would never get what he needed living at home with the limited support available to her. When the hospital called for her to pick up Jaylen, she said no.
Manning is not alone.
This story continues after the gallery.
Keeping Jaylen Manning | Photos
Hospitals say it's a problem
A representative of Piedmont Healthcare spoke candidly to the Behavioral Health Reform and Innovation Commission, BHRIC, a group of lawmakers and advocates meeting in between legislative sessions to make recommendations on policy.
“So we absolutely are having patients that do hit 100 plus days sitting in our emergency rooms or on our medical floor beds,” said Fiona Hall, the Executive Director of Piedmont’s Behavioral Health Service Line, adding, “This is a daily, daily, daily situation.”
Dr. Dejuan White, a psychiatrist with Grady Hospital, told the committee Piedmont wasn’t the only hospital with this problem.
“It looks like we’re seeing about 10 times the patients in the Atlanta area with our emergency department,” said White.
Federal data shows the number of people going to the ER for a mental health or substance use disorder in Georgia has increased nearly 20 percent in the past decade. More than half of those people, 59 percent, don’t have insurance or rely on Medicaid. They are the ones getting stuck.
Piedmont told the committee to get those people care the hospital has started to pay for it themselves, spending $3 million dollars in 2021, according to its report.
Despite repeated requests, neither hospital would talk with 11Alive about the problem, share data, or answer our written questions about the problem.
In a budget hearing before lawmakers in January, the commissioner for the state’s Department of Behavioral Health and Developmental Disabilities, or DBHDD, said his staff was working to find placement for 27 people stuck in ERs waiting for crisis care or placement in a longer term facility.
Staffing is a big part of the problem.
Many providers that would have helped care for these people saw a mass exodus of workers during the pandemic. Even as the community returns to normal, many of those workers have found less stressful jobs in retail or fast food, making more money.
ARCHI, a non-profit that meets with hospitals regularly to find solutions to problems like this one, also presented to BHRIC. It shared cases like:
- A non-verbal person with Downs Syndrome that spent 80 days in Northside Hospital after being found sitting next to a deceased caregiver.
- A 22-year-old man in the ER since October 14 who was a risk to himself, patients, and staff. Even though he was medically stable, neither his group home nor any other placement would take him. The presentation was last November, ARCHI nor Piedmont will say if he’s still there.
- An 18-year-old with fetal alcohol syndrome and an intellectual disability left by her adoptive mother, spent three months at Grady until she could get proper assessments and legal aid support.
Testimony from those groups has led members of BHRIC to recommend the state develop more acute autism crisis stabilization units and increase Medicaid reimbursement to get more therapists in-network.
A Senate study committee has also recommended the state increase the number of people who can receive special waivers that help pay for supportive services and to increase pay for those frontline workers to $15 an hour.
DBHDD is in the process of building a first-of-its-kind facility for Georgia to provide crisis stabilization and diagnostic services for adults with developmental disabilities. But it will take years before the facility opens.
This story continues after the video.
What one mom is doing to help
So Manning is doing what she can do, now. She has started Magenta Momz.
“The color is a significant part of us just having to always be the person pushing our children forward. It’s a powerful, powerful color,” she explained.
The non-profit supports the mental health of mothers of children with special needs by helping to educate, encourage, and provide opportunities for self-care.
“I just think that if I hadn’t had the exposure with 11Alive, if we hadn’t had an advocate and the Georgia Advocacy Office, if I hadn’t contacted Sen. Ossoff and other representatives and done a million things that I did, I really think that we’d still be in crisis," she said. "So, I just imagine the families that haven’t been able to call the right person.”
Manning’s son is now at a crisis stabilization home where he can get his medication and behavior back under control. She hopes to move him into a group home where he can stay involved in activities and get around-the-clock care.
“I’m going to fight with every breath that I have to make sure that he gets what he needs,” said Manning.
11Alive started following the challenges Manning and her son faced as part of our series #Keeping, an in-depth look at the costly gaps in our system of care that tear families apart.
If you have a loved one that spent more than a week in a Georgia hospital waiting for transfer, we want to hear your story. Email rlindstrom@11alive.com.