Written by Doug Wallace
From 2011 to 2020, the number of mental health visits in pediatric EDs increased from 7.7% to 13.1% of all encounters, with a significant increase in the proportion of suicide-related visits.
Why does this matter?
Mental health presentations continue to be a significant portion of pediatric ED visits and are rapidly increasing despite limited availability of mental health resources. Less than 20% of mental health related ED visits included evaluation by a mental health professional in this study, with no change in this proportion over the sampled time frame. Related findings have been demonstrated in multiple studies (Mental Health Follow Up, Suicidal Teens, Suicide Risk in Teens), and this study was also referenced in the New York Times.
The proportion of ED pediatric mental health visits has nearly doubled over the last 10 years
The authors performed a cross-sectional survey of national publicly available data from 2011-2020 (NHAMCS). Key findings were that the proportion of mental health-related visits increased from 7.7% to 13.1% of all encounters in pediatric EDs, with the largest increase in visits among ages 10-14. These findings were uniform across race, sex, and ethnicity. Suicide-related visits increased the most, from 0.9% to 4.2% of all encounters (23.1% average annual change).
My takeaways: The study results are concerning, and my own clinical experience tracks with the author’s findings. These trends undoubtedly have complex etiologies, including limited access to care, increasing incidence of pediatric mental health issues, and multifaceted socioeconomic factors. With only 20% of these patients being evaluated by a mental health professional during the ED visit, this study further highlights a critical need for expansion in pediatric mental health care resources on a national level.
National Trends in Mental Health-Related Emergency Department Visits Among Youth, 2011-2020. JAMA. 2023 May 2;329(17):1469-1477. doi: 10.1001/jama.2023.4809.