Child Mental Health Services in the Emergency Department: Disparities in Access

Area of Science:

• Pediatric mental health services
• Health services research
• Emergency medicine

Background:

• Emergency departments (EDs) are increasingly utilized for pediatric mental health care.
• A significant proportion of these pediatric ED visits are for children insured by Medicaid.
• Understanding the characteristics of these children is crucial for improving access to care.

Purpose of the Study:

• To examine the characteristics of children with Medicaid presenting to Florida hospital EDs for psychiatric conditions.
• To identify factors associated with increased likelihood of psychiatric ED visits among children with Medicaid.

Main Methods:

• Retrospective research design utilizing insurance claims data.
• Analysis of children's ED visits for mental health care.
• Logistic regression modeling to assess predictor variables (age, race, ethnicity, sex, mental health professional shortage area).

Main Results:

• All five predictor variables (age, race, ethnicity, sex, and residence in a mental health professional shortage area) were significantly associated with psychiatric ED visits for children with Medicaid.
• These factors increase the odds of a child with Medicaid utilizing the ED for mental health reasons.

Conclusions:

• The ED serves as a critical entry point into the mental health system for children with Medicaid.
• Identifying at-risk populations can inform targeted interventions and improve care pathways.