Quality of Life for Children With Mental and Behavioral Health Emergencies in the Pediatric Emergency Department

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Updated: May 22, 2025

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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

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Nina Friedman1, Nicole Gerber2, Kathleen Morton2

  • 1Division of Child Life, Department of Pediatrics, NewYork-Presbyterian.

Pediatric Emergency Care
|May 20, 2025
PubMed

Insights

Children with mental/behavioral health (MBH) emergencies experienced worse Quality of Life (QoL) during pediatric emergency department (PED) boarding. Their QoL did not improve and often worsened, indicating a critical need for better emergency care.

Area of Science:

  • Pediatric Emergency Medicine
  • Child and Adolescent Psychiatry
  • Quality of Life Research

Background:

  • Hospital admissions significantly impact children's Quality of Life (QoL).
  • Limited understanding exists regarding QoL for children with mental/behavioral health (MBH) emergencies during pediatric emergency department (PED) boarding.
  • MBH emergencies represent a growing concern within pediatric healthcare settings.

Purpose of the Study:

  • To investigate and analyze the Quality of Life (QoL) among children experiencing mental/behavioral health (MBH) emergencies while boarding in a pediatric emergency department (PED).
  • To compare QoL trajectories between children with MBH emergencies and control groups.
  • To identify factors influencing QoL outcomes in this vulnerable pediatric population.

Main Methods:

  • A prospective, observational study was conducted in an urban pediatric emergency department (PED) over one year.
  • Participants included youth aged 8-17 years with MBH emergencies and control groups (extremity fracture or chronic medical illness).
  • The validated Pediatric Quality of Life Present Functioning Visual Analogue Scale was used to compare QoL scores and trajectories, with data analyzed using Wilcoxon rank sum test and multivariable linear regression.

Main Results:

  • Children with MBH emergencies reported significantly worse QoL at both presentation and disposition compared to controls.
  • The MBH group exhibited less QoL improvement, with a substantial percentage (24%) showing no improvement and 29% experiencing a decline in QoL.
  • Multivariable regression confirmed that MBH patients had poorer QoL total symptom score improvement (P=0.02).

Conclusions:

  • Pediatric patients with MBH emergencies demonstrate a lack of QoL improvement, and often experience worsening QoL, while boarding in the PED.
  • These findings underscore the urgent necessity to enhance the emergency care experience for children with MBH conditions.
  • Prioritizing interventions and care strategies within the PED is crucial for improving outcomes for these children.
Abstract

Keywords:
boardingemergency medicinemental healthquality of life

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