Long Emergency Department Waits Plague youth Mental health Care

A recent study reveals that approximately one-third of pediatric mental health Emergency Department (ED) visits, which result in either admission or transfer, exceed 12 hours. Furthermore, over one in eight visits extend beyond 24 hours, according too data spanning from 2018 to 2022. The study highlights that 70% of children experiencing ED stays longer then 12 hours are there due to suicidal thoughts or attempts, while over half are present because of aggressive behaviors.

Prolonged ED Stays Highlight Systemic Issues

The research is published in the journal JACEP Open.

“Our study underscores significant issues with access to mental health care for children and adolescents, who frequently enough face prolonged ED stays as a psychiatric bed is not available,” said lead author jennifer Hoffmann, MD, MS, Behavioral Health Medical Director, Emergency Medicine at Ann & Robert H. Lurie Children’s Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

“As the youth mental health crisis continues, we have been seeing more severe psychiatric conditions in the ED. Most of these kids seek emergency care at adult hospitals, which frequently enough have more limited pediatric resources compared to children’s hospitals and might not be prepared to provide the necessary supports.”

The study sample represented all pediatric ED visits for mental health concerns in the U.S., with only 1% occurring at children’s hospitals. Dr. Hoffmann emphasized that continued funding is crucial for the Emergency Medical Services for Children (EMSC), a federal program that trains non-pediatric hospitals nationwide in providing efficient and effective care for youth in the ED.

insurance Disparities and Potential Solutions

Dr. Hoffmann and her team analyzed records representing 5.9 million mental health ED visits by children aged 5-17 over four years.Approximately 1.4 million of these visits resulted in admission or transfer.

The study revealed that youth with public insurance were more likely to remain in the ED for over 12 hours while awaiting a psychiatric bed, highlighting disparities in access to mental health services.

“Differences in reimbursement rates for psychiatric services, which are frequently enough lower with public relative to private insurance, may contribute to inequities in care access,” Dr. Hoffmann noted.

In addition to addressing medicaid reimbursement rates for pediatric mental health care and ensuring sustained funding for EMSC, Dr.Hoffmann suggested several potential solutions to improve mental health care access for youth. These include increased use of telehealth, school-based mental health services, and integrating mental health care into primary care settings. She also mentioned the potential of psychiatric urgent care clinics and free-standing psychiatric EDs to meet the growing demand for these services among children and adolescents.

Background: The Youth Mental Health Crisis

The escalating youth mental health crisis is a significant public health concern, marked by rising rates of anxiety, depression, and suicidal ideation among young people. Factors contributing to this crisis include academic pressures,social media influence,family dynamics,and broader societal stressors. Limited access to mental health services,particularly in underserved communities,exacerbates the problem,leading to increased emergency department visits and prolonged wait times for appropriate care.

Addressing this crisis requires a multi-faceted approach, including increased funding for mental health programs, improved integration of mental health services into schools and primary care settings, and efforts to reduce stigma associated with mental illness. Telehealth and innovative care models, such as psychiatric urgent care clinics, also hold promise for expanding access to timely and effective mental health support for youth.

Source: Information adapted from original article.

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