Pediatric mental health emergency department visits from 2017 to 2022: A multicenter study
Jennifer A Hoffmann1, Camille P Carter2, Cody S Olsen2
1Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Insights
Pediatric mental health (MH) emergency department (ED) visits decreased overall during the COVID-19 pandemic. However, visits for specific conditions and by females remained elevated, highlighting a need for targeted MH care.
Area of Science:
- Pediatric Emergency Medicine
- Child and Adolescent Psychiatry
- Public Health
Background:
- The COVID-19 pandemic significantly impacted children's mental health (MH).
- Patterns of MH emergency department (ED) utilization among children changed during the pandemic.
- Prepandemic trends in pediatric MH ED visits provide a baseline for comparison.
Purpose of the Study:
- To assess how pediatric MH ED visits during the COVID-19 pandemic differed from expected prepandemic trends.
- To analyze changes in the duration of pediatric MH ED visits.
- To identify demographic and clinical factors associated with altered MH ED utilization.
Main Methods:
- Retrospective study of pediatric MH ED visits (ages 5 to <18) from 2017 to 2022.
- Utilized data from nine U.S. hospitals in the Pediatric Emergency Care Applied Research Network Registry.
- Employed multivariable Poisson regression to estimate expected visit rates and calculated rate ratios (RRs) for observed vs. expected visits.
Main Results:
- A total of 175,979 pediatric MH ED visits were identified.
- Visit lengths exceeding 12 hours increased significantly from prepandemic (7.3%) to late pandemic (19.2%).
- Overall pediatric MH ED visits decreased during the early (RR 0.80) and late (RR 0.92) pandemic, but were similar during the midpandemic (RR 1.01).
- Late pandemic visits were higher than expected for females (RR 1.10) and for bipolar disorder (RR 1.83), schizophrenia spectrum (RR 1.55), and substance-related disorders (RR 1.50).
Conclusions:
- Pediatric MH ED visits declined below expected rates during the late pandemic.
- Elevated visit rates for females and specific disorders suggest a need for focused interventions.
- Increased ED visit lengths may indicate insufficient outpatient MH services availability.
Background:
The COVID-19 pandemic adversely affected children's mental health (MH) and changed patterns of MH emergency department (ED) utilization. Our objective was to assess how pediatric MH ED visits during the COVID-19 pandemic differed from expected prepandemic trends.
Methods:
We retrospectively studied MH ED visits by children 5 to <18 years old at nine U.S. hospitals participating in the Pediatric Emergency Care Applied Research Network Registry from 2017 to 2022. We described visit length by time period: prepandemic (January 2017-February 2020), early pandemic (March 2020-December 2020), midpandemic (2021), and late pandemic (2022). We estimated expected visit rates from prepandemic data using multivariable Poisson regression models. We calculated rate ratios (RRs) of observed to expected visits per 30 days during each pandemic time period, overall and by sociodemographic and clinical characteristics.
Results:
We identified 175,979 pediatric MH ED visits. Visit length exceeded 12 h for 7.3% prepandemic, 8.4% early pandemic, 15.0% midpandemic, and 19.2% late pandemic visits. During the early pandemic, observed visits per 30 days decreased relative to expected rates (RR 0.80, 95% confidence interval [CI] 0.78-0.84), were similar to expected rates during the midpandemic (RR 1.01, 95% CI 0.96-1.07), and then decreased below expected rates during the late pandemic (RR 0.92, 95% CI 0.86-0.98). During the late pandemic, visit rates were higher than expected for females (RR 1.10, 95% CI 1.02-1.20) and for bipolar disorders (RR 1.83, 95% CI 1.38-2.75), schizophrenia spectrum disorders (RR 1.55, 95% CI 1.10-2.59), and substance-related and addictive disorders (RR 1.50, 95% CI 1.18-2.05).
Conclusions:
During the late pandemic, pediatric MH ED visits decreased below expected rates; however, visits by females and for specific conditions remained elevated, indicating a need for increased attention to these groups. Prolonged ED visit lengths may reflect inadequate availability of MH services.
More Related Videos
08:25Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment
Published on: December 6, 2024
05:48The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients
Published on: June 12, 2020
Related Concept Videos
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....