Children’s visits to emergency departments (EDs) for mental health disorders rose by 60% over a decade and many are at hospitals that may not be equipped to care for pediatric patients, a new study found.
About 20% of U.S. children have a mental health disorder. Researchers analyzed 2007-’16 data from the Nationwide Emergency Department Sample databases on children ages 5-17 to look at how often these children are using EDs for care. The results were published today in "Children's Mental Health Emergency Department Visits —2007-2016," (Lo CB, et al. Pediatrics. May 11, 2020, https://bit.ly/2Wbo6wb)
The 60% increase authors found occurred while total ED visits were stable. The study showed visits for
- self-harm rose 329%,
- substance-use disorders not including alcohol rose 159%,
- anxiety disorders rose 117%,
- impulse disorders rose 111% and
- alcohol-related disorders fell 39%.
ED visits for mental health rose for both boys and girls and across all ages, including a 68% jump for those ages 15-17.
They also rose at urban and rural locations, hospitals of varying sizes and among children’s hospitals and non-children’s hospitals.
“Our findings of increased pediatric ED visits for mental health at smaller volume EDs in rural centers are concerning given the potential decreased pediatric readiness for children with mental health problems,” authors wrote.
EDs can improve preparation by using online trainings and toolkits such as the Critical Crossroads: Pediatric Mental Health in the Emergency Department from the Health Resources and Services Administration (http://bit.ly/2Vo1czK), according to the report. Authors also said telehealth, partnerships with other institutions and screening all behavioral health patients for suicidal ideation can help improve care.
“Integration of mental health services into the pediatric medical home will be critical to improve access to care and reduce ED visits,” according to a related commentary (https://bit.ly/3ckeMMd). “Meanwhile, to serve the rising demand for emergency mental health services, every ED across the country must do the hard work required to be ready to provide high quality mental health care for each child who walks through its doors.”