Children’s Hospital Colorado continues to see high volumes of pediatric patients, with an influx of mental health patients to emergency rooms causing the hospital to sometimes open up overflow space in a tent outside of the building.

The facility has not maxed out its capacity and is still taking patient transfers, associate chief medical officer Kevin Carney said Thursday. But levels have not dropped since early August, when an unprecedented spike in RSV patients – a common but sometimes serious respiratory infection – began to arrive at Children’s.

The tent, neither a standing nor completely unique addition, has at times been opened in Aurora to more rapidly work through patients, as wait times inside the emergency department have caused patients to wait sometimes “hours or even days” for a bed.

Though COVID-19 has been spreading among children in higher numbers than anyone else amid this latest surge, the virus is playing a “backseat” role to RSV and mental health patients. Carney said 40% of Children’s emergency department rooms “have patients with primary mental health issues in them.” 

“Certainly those patients need our care just as much as patients with medical illness, but the challenge is that as we have mental health patients who are staying sometimes in our emergency rooms for many, many hours or even days as they await an inpatient bed, it has a major impact just because it becomes harder to take care of all the other patients who are arriving for medical issues,” he said.

The tent, he said, has been used before, at the beginning of the pandemic and in previous years, when there were sudden influxes of patients. It is not being used daily at Children’s.

Because of the high volume, patients in the ER are being “boarded” there, meaning kept in exam rooms while the facility waits for another bed to open up. The staffing shortages plaguing hospitals statewide are also affecting Children’s, Carney said. 

The typical peak of the respiratory season is still at least a month away, based on past years. Though the situation hasn’t worsened in terms of RSV since August, Carney said the influx of mental health patients is straining the hospital.

“The days we have to employ the tent is when we’re really seeing huge backups in our emergency department because of the mental health volumes of patients,” he said.

In Colorado, Children’s has consistently warned about the youth mental health crisis. In May, the system declared a state of emergency for behavioral health in juveniles. 

There are a number of factors likely contributing to the crisis, Carney said. Some of the factors, and the trend overall, predates the pandemic. The isolation, stress and lack of social contact over the past 20 months has further exacerbated it. 

Despite suggestions to the contrary, Carney emphasized that there is no evidence to suggest mask wearing in schools is harming students’ mental health. Representatives from Children’s have previously emphasized that fact during public meetings about masks in schools.

“We don’t believe there’s any evidence that would suggest that mask wearing is what is leading to the spike in mental health crises with our youth,” he said. “That is really something that we have not seen any evidence for, and if anything, wearing masks and getting kids safely back into schools is what they need to help socialize and really help with a lot of the social isolation that people experienced early on in the pandemic.”