From 2012 through 2016, the number of children and adolescents visiting the nation's emergency departments due to mental health concerns continued to rise at an alarming rate, according to a retrospective cross-sectional study presented during the American Academy of Pediatrics National Conference & Exhibition.
"Our findings underscore the importance of improving access to outpatient mental health resources as well as expanding capacity within the nation's emergency departments to respond to this unmet need,"Monika K. Goyal, M.D., MSCE, assistant division chief and director of research in the Division of Emergency Medicine at Children's National Health System and the study's senior author.
‘Access to mental health services among children can be difficult, and data suggest that it can be even more challenging for minority children compared with non-minority youths. ’
An estimated 17.1 million U.S. children are affected by a psychiatric disorder, making mental health disorders among the most common pediatric illnesses. Roughly 2 to 5 percent of all emergency department visits by children are related to mental health concerns. The research team hypothesized that within that group, there might be higher numbers of minority children visiting emergency departments seeking mental health services.
To investigate this hypothesis, they examined Pediatric Health Information System data, which aggregates deidentified information from patient encounters at more than 45 children's hospitals around the nation. Their analyses showed that in 2012, 50.4 emergency department visits per 100,000 children were for mental health-related concerns. By 2016, that figure had grown to 78.5 emergency department visits per 100,000 children.
During that same five-year time span, there were 242,036 visits by children and adolescents 21 and younger with mental health-related issues*. Within that group:
The mean age was 13.3
Nearly 55 percent were covered by public insurance
78.4 per 100,000 non-Latino black children received mental health-related diagnoses and
51.5 per 100,000 non-Latino white children received mental health-related diagnoses.
"When stratified by race and ethnicity, mental health-related visits to the nation's emergency departments rose for non-Latino black children and adolescents at almost double the rate seen for non-Latino white children and adolescents," Dr. Goyal adds. "These children come to our emergency departments in crisis, and across the nation children's hospitals need to expand mental health resources to better serve these vulnerable patients."
Because the study did not include reviews of individual charts or interviews with patients or providers, the reason for the disparate demand for mental health resources remains unclear.
*The number of patient visits during the five-year study period was revised on Nov. 1 2018, after updated analyses.
American Academy of Pediatrics National Conference & Exhibition presentation
Friday, Nov. 2, 2018
"Racial disparities in pediatric mental health-related emergency department visits: a five-year, multi-institutional study." 4:15 p.m. to 4:30 p.m. (ET)
Anna Abrams, M.D.; Gia Badolato, MPH; William Pastor, MS; and Monika K. Goyal, M.D., MSCE