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Characteristics of Young Children Presenting to the Emergency Department for Psychiatric Evaluation

Muhammad Waseem1, Afaf F Moustafa2, Kathryn D Esposito3

  • 1Department of Emergency Medicine, NYC Health + Hospitals/Lincoln, Bronx, New York.

The Journal of Emergency Medicine
|November 22, 2025
PubMed

Insights

Young children with behavioral concerns frequently visit emergency departments (ED). Higher adverse childhood experiences (ACEs) correlate with repeated ED visits, longer stays, and increased risks for disabilities and suicidal thoughts.

Area of Science:

  • Pediatric Emergency Medicine
  • Child Psychiatry
  • Public Health

Background:

  • Emergency departments (ED) face a crisis with increasing pediatric behavioral health visits.
  • These visits place young children at higher risk for emotional and mood disorders.

Purpose of the Study:

  • Identify factors contributing to disruptive behavior in children.
  • Examine characteristics associated with pediatric ED visits for behavioral concerns.
  • Highlight the need for targeted interventions.

Main Methods:

  • Retrospective review of 184 pediatric ED records (2015-2021).
  • Data included demographics, psychiatric comorbidities, social history, and adverse childhood experiences (ACEs).
  • Compared patients with and without prior ED visits for psychiatric evaluations.

Main Results:

  • Common behavioral issues included aggression, suicidal ideation, and acting out.
  • Attention-deficit/hyperactivity disorder was the most frequent diagnosis (40%); 52% had no prior diagnosis.
  • Children with prior ED visits had higher ACEs scores, longer ED stays, and more disabilities and suicidal thoughts (p < 0.05).

Conclusions:

  • Pediatric ED visits for behavioral health issues are cyclical, particularly for children with high ACEs.
  • Findings emphasize the need for early identification and coordinated care strategies.
  • Further research is required to interrupt the cycle of repeated ED visits.
Abstract

Keywords:
ED admissionbehavioral encounterbehavioral healthpsychiatric evaluation

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