A recent study published in the journal JACEP Open reveals that approximately one in three pediatric mental health emergency department (ED) visits resulting in admission or transfer exceeded 12 hours. Over one in eight of these visits lasted more than 24 hours.
The data, based on a nationally representative sample from 2018 to 2022, highlights a significant issue with access to mental health care for children and adolescents.
The study found that 70% of all children who stayed in the ED for over 12 hours were there due to suicidal thoughts or attempts, while over half were admitted for aggressive behaviors. Dr. Jennifer Hoffmann, the lead author of the study and Behavioral Health Medical Director at Ann & Robert H. Lurie Children’s Hospital of Chicago, emphasized the severity of the situation.
“Our study underscores significant issues with access to mental health care for children and adolescents, who often face prolonged ED stays because a psychiatric bed is not available,” she said.
The study evaluated records representing 5.9 million mental health ED visits by children aged 5 to 17 over a four-year period. An estimated 1.4 million of these visits resulted in admission or transfer. The findings also revealed that youth with public insurance were more likely to remain in the ED for more than 12 hours waiting for a psychiatric bed.
Dr. Hoffmann explained that differences in reimbursement rates for psychiatric services, which are often lower with public compared to private insurance, may contribute to inequities in care access.
As the youth mental health crisis continues, the study highlights the need for sustained funding for the Emergency Medical Services for Children (EMSC), a federal program that provides training to non-pediatric hospitals across the country in the efficient and effective care for youth in the ED.
Dr. Hoffmann emphasized that most children seek emergency care at adult hospitals, which often have more limited pediatric resources compared to children’s hospitals and might not be prepared to provide the necessary supports.
The findings underscore the urgent need for improved access to mental health care for children and adolescents. With continued funding and innovative solutions, it is hoped that the prolonged ED stays and inequities in care can be addressed to better support youth in mental health crisis.
