Study results show that visits to the emergency department for young people with mental health problems have risen sharply

The news

Visits to mental health emergency rooms by children, teens and young adults increased sharply from 2011 to 2020, according to a report published Monday in the Journal of the American Medical Association. The largest increase was in suicide visits, which increased fivefold. According to the team of researchers and doctors that published the report, the findings indicated an “urgent” need for expanded crisis services.

The study, based on data from the National Hospital Ambulatory Medical Care Survey, looked at the annual number of psychiatric emergency room visits for people aged 6 to 24 years. From 2011 to 2020, the number jumped from 4.8 million to 7.5 million, the team found, a period during which the total number of pediatric emergency department visits declined. In fact, the proportion of emergency room visits for mental health issues has roughly doubled, from 7.7 percent to 13.1 percent.

Visits increased for many conditions, including mood and behavior disorders, drug use and psychosis. Most notable, however, was the increase in suicide problems, which rose from 0.9 percent in 2011 to 4.2 percent of all pediatric emergency departments in 2020.

Why it matters

An increasing number of children and young people are struggling with mental health problems, but medical systems have not kept pace. Inadequate treatment options and the availability of preventive care mean that many families seek help in emergency departments that are ill-equipped to deal with mental health issues. A recent New York Times investigation found that hundreds of young people sleep in emergency rooms each night while waiting to be admitted to appropriate treatment programs.

“A committed national commitment will be required to close the gaps,” the JAMA paper concluded.

background

For many decades, the country’s medical infrastructure was built to help young people with infections, broken bones and other injuries sustained in accidents. While these problems persist, there has been a significant shift in the nature of the conditions affecting children, adolescents and young adults. In 2019, the American Academy of Pediatrics published a report that found “mental health disorders have outpaced physical conditions” as the most common problems causing “disabilities and limitations” in adolescents.

Pediatric training has not kept pace, and emergency departments serve as patient triage rather than psychiatric units, although inpatient and outpatient treatment options have eroded.

What’s next

The JAMA investigation describes a “critical need” to expand treatment options outside of the hospital setting, including programs in schools and more outpatient centers and emergency clinics with 24-hour service. Some state and federal legislatures are looking at ways to expand coverage to reflect the changing risks young people face.