Trends in Pediatric Mental Health-Related Emergency Department Visits During the School Year and School Breaks

We examined patient and visit trends in pediatric emergency department (ED) usage during the school year and summer breaks before, during, and after the COVID-19 pandemic.

We extracted data on mental health-related visits to the ED of an academic medical center from 2018 to 2023 among youth aged 5-18. Data were visualized, and overall visit frequency was modeled via piecewise linear regression. Odds ratios were estimated for characteristics associated with suicidal ideation and inpatient admission.

A total of n = 2536 unique individuals had 3358 ED encounters resulting in a mental health-related diagnosis. Visit frequency was flat from August 2018 to a nadir in August 2020, followed by an increase. Female patients had increased odds of ED visits (OR = 1.45; 95% CI: 1.24-1.69) compared to males. Visits during school breaks were associated with increased odds of inpatient admission compared to visits during school sessions (OR = 1.30; 95% CI: 1.08-1.56).

Schools are an important site for mental health promotion and can collaborate with EDs and community providers to support students before breaks.

Students may experience a decrease in school-related stress during breaks, but a lack of access to school-based mental health support may be one factor related to increased ED visits requiring inpatient admissions.