Many kids today have no safety net for their mental health problems. When they can’t cope, they often wind up in a hospital emergency room, where they may or may not get the specific help they need.

It’s often the last resort for parents like Margo Jones (not her real name), who lack accessibility to psychological services or can’t afford them.

Forty percent of ER admissions are for mental health issues, yet a psychiatrist or mental health clinician may not be available.

Jones of Niles, Illinois, wasn’t sure how to help her 13-year-old daughter, Christy, when she began locking herself in her room and crying uncontrollably over an unspecified problem. Her daughter seemed to be growing more agitated and “hyper” — Jones initially attributed the changes in her behavior to entering a new school.

But when her behavior escalated and she began throwing herself around her room, intentionally hitting her head, Jones and a neighbor took the girl to a hospital.

“I really didn’t know what else to do,” Jones told LifeZette. “But we were low-priority because people were bleeding all around. We waited over six hours, trying to calm her down every time she lost it. We finally got a doctor [to examine her] and by then she was exhausted and didn’t seem so bad off. They gave her a shot and gave me a list of psychiatrists I couldn’t afford.”

After two months on a wait list, her daughter was diagnosed with a mental disorder, through a counseling service Jones found through her church.

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Forty percent of emergency rooms admissions are for mental health issues, yet a psychiatrist or mental health clinician may not be available. Many emergency room doctors don’t have expertise in diagnosing mental illness or dispensing the medications typically used, especially to children.

[lz_bulleted_list title=”Mental Health Issues Among Children” source=””]Mental health conditions are common among teens and young adults|1 in 5 live with a mental health condition — half develop the condition by age 14 and three-quarters by age 24|Despite effective treatment, there are long delays — sometimes decades — between the first appearance of symptoms and when people get help[/lz_bulleted_list]

Compared with patients who have physical illnesses, researchers from Stanford University recently found that people with mental health conditions rely more on the emergency department. They are more likely to be admitted when they show up and they also tend to stay longer. Children and older patients are often most affected, according to Suzanne Lippert, a clinical assistant professor in emergency medicine at Stanford.

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In addition, this population also often falls through the cracks. Emergency room patients with mental health conditions see less follow-up care after leaving the hospital, either due to lack of awareness of the need for extended care, or because the patient is unable to pay for appropriate care. Children living in rural communities have a harder time finding mental health care than those in urban environments.

And many parents simply miss the signs.

“Children may complain of stomach aches, or pains that have no physical causes, and it can be easy to unintentionally ‘talk them out of’ their complaints and send them back to class,” said Maegan Kern Bregenser, family assistance crisis coordinator at Agora Cyber Charter School in King of Prussia, Pennsylvania.

Key signs are disrupted sleep, changes in eating habits, sudden weight gain or loss, isolation at school or home, and dips in academic performance and grades.

“They may not draw attention to themselves at all. Many parents accept withdrawn, quiet, moody behaviors as ‘typical’ for teenagers, and will often normalize these behaviors and even pull away in an attempt to give them space and privacy. When this happens, the risk of missing important signs becomes even greater,” she told LifeZette.

She cautions parents to look for changes in mood, affect, and behaviors in their children, as well as anxiety, withdrawal, and uncontrolled emotions, like sadness, anger, and rage. Other key signs are disrupted sleep, changes in eating habits, sudden weight gain or loss, isolation at school or home, and dips in academic performance and grades. Any child who self-harms should be in active mental health care.

If parents can’t afford traditional care through their health care insurance, Dan Thorne, a licensed marriage and family therapist in Orange County, California, suggests following up on referrals from school counselors, community organizations, churches, the Boys and Girls Club, YMCA, or YWCA.

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One concern with that, according to Thorne: “School staff are too busy to do counseling; they can only deal with crises and make recommendations to the parents,” he said.

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As the crisis in mental health care for kids grows, Dr. John Mayer of Chicago, Illinois, decided to chip in the best way he knows. He volunteers to support counseling departments in schools, donating his time and expertise. He encourages other psychologists to do the same.

“Sending kids to an ER is a horrible alternative,” he said. “We need to get involved in a solution.”

Pat Barone, MCC, is a professional credentialed coach and author of the Own Every Bite! bodycentric re-education program for mindful and intuitive eating, who helps clients heal food addictions.