A large study published in JAMA Pediatrics in December proves a trend that children’s hospitals have been experiencing for years: overall visits to pediatric emergency rooms for mental health crises increased 43% from 2015 to 2020. Annually, mental health visits rose 8%, while all other visits rose 1.5%.
Researchers from Children’s Hospital Los Angeles and Boston Children’s Hospital analyzed more than 308,000 mental health visits at 38 hospitals using CHA’s Pediatric Health Information System (PHIS). The study revealed factors associated with mental health ED visits that the authors said would help with resource allocation and interventions tailored to high-risk patients. Some key points include:
- The most common diagnosis groups were suicidal ideation or self-harm (28.7%) and mood disorders (23.5%).
- Patients presenting with somatic disorders, trauma disorders, suicidal ideation or self-harm, and eating disorders had the largest increases in ED visits.
- The majority of patients with mental health ED visits were females, non-Hispanic white, had public insurance, and lived in an urban area.
About 13% of patients revisited the ED within six months. Those with suicidal or self-harming behavior, which made up the largest portion of mental health ED visits, were not the most likely to return. Patients with psychotic disorders were 42% more likely to revisit, followed by patients with impulse control disorders and neurodevelopmental disorders. Additionally, public insurance and a higher Child Opportunity Index were associated with shorter time to mental health ED revisits.