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A higher proportion of children’s emergency department (ED) visits since mid-March has been related to mental health struggles than in 2019, a new study found.
“Many mental disorders commence in childhood, and mental health concerns in these age groups might be exacerbated by stress related to the pandemic and abrupt disruptions to daily life associated with mitigation efforts, including anxiety about illness, social isolation, and interrupted connectedness to school,” researchers from the Centers for Disease Control and Prevention (CDC) wrote in a new Morbidity and Mortality Weekly Report.
The team analyzed hospital data on children under 18 years from the CDC’s National Syndromic Surveillance Program. They found from mid-March through mid-October of 2020, the average number of ED visits by children each week for any cause and for mental health were down 43% and 19%, respectively compared to 2019. However, the proportion of the ED visits that were for mental health rose by 44%. About 1,673 of every 100,000 visits were for mental health during that period in 2020 compared to 1,161 of every 100,000 visits in 2019.
Adolescents ages 12-17 made up the largest proportion of ED visits for mental health. The proportion of their ED visits for mental health was 31% higher in 2020 compared to 2019. For children ages 5-11 years, the proportion of mental health visits was up 24%.
Authors said the findings suggest “that children’s mental health warranted sufficient concern to visit EDs during a time when nonemergent ED visits were discouraged.”
They also noted some children may not have been able to access their usual clinic or community agency for mental health services.
The authors highlight potential limitations of the data in over or underestimates because of small numbers of mental-health related ED visits; reporting hospitals are not a nationally representative sample; and variation in reporting and coding practices. The findings also could be artificially inflated due to overall ED visits declining sharply during this period.
Still, authors stressed the importance of monitoring children’s mental and emotional health during the pandemic and making sure they have access to care. Both the short-term and long-term effects of public health emergencies on children’s mental health and their overall health and well-being should continue to be monitored and addressed.
“Ensuring availability of and access to developmentally appropriate mental health services for children outside the in-person ED setting will be important as communities adjust mitigation strategies,” they wrote. “Implementation of technology-based, remote mental health services and prevention activities to enhance healthy coping and resilience in children might effectively support their well-being throughout response and recovery periods.”
The AAP recently released new interim guidance on how pediatricians can support families’ emotional health during the pandemic. It covers how to evaluate the impact of the pandemic on children, which children may be more vulnerable, when to refer children to a specialist and the role of parents and caregivers in supporting children.
