Study: Rising Rate of Mental Health Visits Among Youth to Emergency Departments

Over the past 10 years, pediatric emergency department (ED) visits for mental health disorders have risen 60% and the rate of visits for deliberate self-harm have increased by 329%, according to a study published by Pediatrics.

Researchers at the Nationwide Children's Hospital looked at the number and reason for mental health-related pediatric ED visits. In addition, they also examined the geographic location of EDs and the overall number of children checking in to each ED.

Previous studies have shown that low pediatric volume EDs and EDs in rural settings are less prepared for all pediatric emergencies, whereas only one-third of rural facilities have pediatric mental health policies or mental health transfer agreements.

Over the study period of 10 years, most visits occurred at non-children's EDs in both metropolitan and non-urban settings. The data are representative of all US emergency departments, among children from 5 to 17 years of age.

The study found that the highest jump in ED visits was among individuals 15 to 17 years of age, which showed a 68% increase. Further, while the rate grew among both males and females, it was more common in girls by 74%.

Visits for substance use disorders rose by 75%, with alcohol-related disorders decreasing by nearly 40% and substance use disorders significantly increasing by more than 150%, according to the study authors. Meanwhile, the rate of visits for deliberate self-harm increased by 329%.

“Examining the characteristics of EDs that children present to was important because outcomes have been shown to be directly linked to the volume and geographic location of the EDs,” said lead study author Charmaine Lo, PhD, MPH, in a press release.

The study authors recommend further research to identify solutions that will better equip all EDs with the tools, personnel, and resources to better manage pediatric cases. One step to improving the quality of care for those being treated for behavioral health conditions, according to the authors, is universal screenings for suicidal ideation.

In addition, telehealth services can also provide an avenue for increasing access to behavioral health specialists who can provide screening, assist with acute interventions, and support connections to continued care within the community, according to the study authors.

“The overall goal of our work is to improve preparedness of EDs for children,” said Rachel Stanley, MD, in a press release. “Large children’s hospitals with psychiatric providers can offer outreach services to these smaller EDs in the form of telehealth. Another solution is more training for emergency physicians and nurses, so they know how to treat and triage children.”

REFERENCE

Study finds rising rate of mental health visits among youth to emergency departments. Nationwide Children’s. https://www.nationwidechildrens.org/newsroom/news-releases/2020/05/mental-health-ed-mmr. Published May 11, 2020. Accessed May 15, 2020.