Emergency visits for suicide-related crises among children surged by 74% from 2016 to 2022, highlighting the urgent need for improved mental health care in emergency departments across the United States.
Emergency visits by children experiencing suicide-related crises in the United States have risen dramatically, according to a recent study published in the Annals of Emergency Medicine. The research, which analyzed over 5 million emergency department (ED) visits for mental health concerns among children from 2016 to 2022, revealed a staggering 74% increase in such visits during this timeframe. This alarming trend underscores significant challenges in the capacity of many hospitals to adequately address the mental health needs of this vulnerable population.
Study Findings and Implications
Approximately half of the suicide-related ED visits, as well as half of all children’s mental health-related visits, occurred in hospitals characterized by lower pediatric volumes, defined as those treating fewer than 10,000 pediatric patients annually. These facilities often lack the specialized resources and training necessary to manage acute mental health crises effectively, which can lead to inadequate care for affected children.
“A child experiencing a mental health crisis may arrive at any emergency department. Our findings underscore the need to equip every ED – not only large pediatric centers – with tools and resources to provide evidence-based mental health care,” said Dr. Audrey Brewer, the lead author of the study and a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago. She is also an Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine.
Dr. Brewer emphasized the importance of training all ED staff in pediatric mental health care and ensuring that facilities have access to mental health professionals, whether onsite or through telehealth services. Furthermore, she highlighted the necessity for universal suicide screening for children in emergency settings, along with creating clear safety plans for families to follow after discharge.
Trends in Pediatric Mental Health Visits
The study found that pediatric mental health-related ED visits increased by 24% overall during the study period, with specific mental health diagnoses including suicide or self-injury accounting for 24% of visits, and depressive disorders representing 23%. Notably, Indigenous children were found to be more likely to seek care at lower pediatric volume EDs, suggesting disparities in access to appropriate mental health resources.
Additionally, youth presenting with substance use concerns were also more frequently seen at these lower-volume facilities. Alarmingly, nearly 30% of children treated for mental health conditions at the smallest pediatric EDs were subsequently transferred to other hospitals for definitive care. This transfer process can create significant delays, resulting in longer wait times in the ED, which can last several days and increase the burden on both children and their families.
“Transfer to another hospital for pediatric mental health care often means a prolonged wait in the ED, sometimes lasting days, increasing the burden on children and their families,” stated Dr. Jennifer Hoffmann, a senior author of the study and a pediatric emergency medicine physician at Lurie Children’s. Also an Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine, Dr. Hoffmann noted that toolkits are available to assist EDs in providing care for children with mental health needs while they await transfer to specialized facilities.
Recommendations for Improvement
Dr. Hoffmann referenced the New England Regional Behavioral Health Toolkit and the National Pediatric Readiness Project as resources that EDs across the country can utilize to enhance their capacity to care for children with mental health issues. She and Dr. Brewer both advocate for the development and testing of ED-based mental health interventions that are specifically designed for children of color, who have been historically underrepresented in mental health research.
“Delivering culturally responsive evidence-based interventions for children in the community and outpatient primary care settings can help to potentially lessen ED reliance for mental health care and may help reduce disparities in youth mental health outcomes,” Dr. Brewer added.
Context of Pediatric Emergency Care
Ann & Robert H. Lurie Children’s Hospital of Chicago, where the study was conducted, is recognized as a leading pediatric institution in Illinois and one of the few independent, research-driven children’s hospitals in the nation. It is dedicated to providing exceptional care for every child and is the pediatric training ground for Northwestern University Feinberg School of Medicine. The hospital is ranked among the top children’s hospitals in the United States by U.S. News & World Report.
As the data demonstrates a significant escalation in the need for pediatric mental health resources, the findings of this study call for urgent action to improve mental health care delivery across emergency departments nationwide. Ensuring that all facilities are equipped to handle the growing mental health crisis among children is essential for safeguarding their well-being and ensuring timely and effective care.
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