More Children Visiting the ED for Mental Health Reasons

Mental health-related visits to the emergency department (ED) continue to rise among children in the United States, with the highest rates observed among non-Hispanic black children, according to a new study.

“Absent other resources in the community, these results indicate a need for increased capacity of pediatric EDs to manage mental health-related complaints, especially among minority populations,” the authors of the study wrote.

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For their study, Ann Abrams, MD, director of research in the Division of Emergency Medicine at the Children’s National Medical Center in Washington, DC, and colleagues evaluated 2012-2016 data from the Pediatric Health Information System. Children aged 21 years or younger with an ICD-9/10 diagnosis for a mental health illness were included in the analysis.

Annual mental health-related ED visits were assessed overall and by race/ethnicity, with categories including non-Hispanic white, non-Hispanic black, Hispanic, and non-Hispanic other. Trends in ED visits over time were also examined.

Ultimately, the investigators identified 293,198 children (mean age 13.3 years) who visited the ED for mental health reasons, translating to a rate of 58,640 per year. Rates of pediatric mental health-related ED visits were found to increase over time, rising from 50.4 visits per 100,000 children in 2012 to 78.5 visits per 100,000 children in 2016.

Data revealed that children identifying as non-Hispanic black (78.4 per 100,000 population; odds ratio [OR] 1.5) and non-Hispanic other (79.2 per 100,000 population; OR 1.5) demonstrated higher rates of mental health-related diagnoses compared with non-Hispanic white children (51.5 per 100,000 population).

Between 2012 and 2016, the rate of mental health-related ED visits had risen at a higher rate among non-Hispanic black children compared with non-Hispanic white children (β = 11.9 and 6.6, respectively).

The findings were presented at the American Academy of Pediatrics National Conference & Exhibition in Orlando, Florida.

—Christina Vogt

Reference:

Abrams A, Goyal M, Badolato G. Racial disparities in pediatric mental health-related emergency department visits: a five-year multi-institutional study. Paper presented at: American Academy of Pediatrics National Conference & Exhibition; November 2-6, 2018; Orlando, FL.