Phillip Niles, a resident of Bridgton and a parent, works in health care operations.

In December, my daughter spent 21 hours in an emergency department waiting for a psychiatric bed to open. We slept in chairs overnight, surrounded by the sounds of a hospital that was never designed to hold a child in mental health crisis. When a bed finally became available, it was nearly three hours from home.

This is not an isolated story. It is the reality for families across Maine.

When a child experiences a mental health crisis, parents are forced into impossible choices: wait indefinitely in an emergency room not equipped for psychiatric care, or send their child far from home to an unfamiliar facility. Either way, families are left to navigate a fragmented system under extreme stress, often with little guidance and even less coordination.

While in the emergency department, my daughter’s psychiatric assessment was conducted via video by a crisis clinician. The hospital staff did their best, but the environment was chaotic and inappropriate for a child in emotional distress. This is not a criticism of the people working there — it is an indictment of a system that relies on emergency rooms to serve as holding spaces for children when no other options exist.

After admission to an inpatient psychiatric facility, we encountered another set of challenges. Discharge planning — the critical bridge between hospitalization and home — became a race against the clock. Essential referrals for home and community-based services required for my daughter’s safety and recovery were delayed due to staffing limitations, system silos and confusion over responsibilities.

In Maine, children discharged from psychiatric hospitalization are eligible for priority placement on waiting lists for intensive in-home supports — but only if referrals are completed before discharge. Miss that window, and families can wait months or even years for services. That is not continuity of care; it is a cliff.

Parents are expected to understand complex waiver systems, eligibility criteria, assessment requirements and referral pathways — all while supporting a child in crisis and managing their own work and family responsibilities. When referrals stall or assessments are incomplete, the burden falls squarely on families to fix what the system cannot.

The emotional toll is immense. My younger child witnessed her sister in crisis. Our family missed Christmas together. We juggled work obligations, long drives and sleepless nights while advocating for services that should have been automatic.

What makes this especially troubling is that many warning signs existed long before hospitalization. Like many parents, I trusted that if a medical screening raised serious concerns, I would be informed and guided toward next steps. Too often, that communication does not happen. The result is escalation — not prevention.

Maine has dedicated clinicians, social workers, nurses and educators who care deeply about children. But they are operating within a system that is understaffed, under-resourced and poorly coordinated. When hospitals, primary care, schools, crisis services and community providers operate in silos, children fall through the cracks.

We must do better.

Maine needs more pediatric psychiatric beds closer to home, clearer discharge standards, guaranteed follow-through on referrals and better communication with families. Emergency departments should not be default psychiatric holding areas for children. Parents should not need to become case managers overnight to secure basic supports.

Mental health care should not depend on how persistent, knowledgeable or lucky a family happens to be. Children deserve timely, coordinated and compassionate care — and families deserve a system that supports them, not one they must fight to navigate.

Until that changes, families like mine will continue to bear the cost of a system that asks far too much when families have already reached their breaking point.