Change in Travel Distance for Pediatric Mental Health Admissions in Illinois, 2016 to 2024

This study analyzes changes in distance travelled by Illinois youth ages 5-17 between 2016 and 2024 for mental health hospitalizations at Illinois hospitals.

We obtained records for admissions with a mental health principal diagnosis in each year. Patient and hospital zip codes were used to estimate distance. We present bivariate and multivariable analyses of change in distance between years by patient and hospital characteristics.

There were 22,516 youth mental health admissions in 2016 to 101 hospitals and 18,316 in 2024 to only 56 hospitals. Hospitalizations of youth who travelled ≥50 miles increased from 15.7% in 2016 to 21.9% in 2024 (p<0.001). Youth who were younger, non-Hispanic White, covered by Medicaid and those from 'downstate' Illinois counties had the longest travel distances. Travel distance ≥50 miles for youth hospitalized for depression increased from 15.4% in 2016 to 23.8% in 2024. As compared to 2016, the adjusted odds of youth having to travel more than 50 or 100 miles in 2024 were 1.76 (95% CI=1.36-2.28) and 2.05 (95%CI=1.30-3.24) respectively.

By 2024, more than one in five children traveled ≥50 miles and one in ten traveled ≥100 miles to access mental health hospital care. The odds of travel ≥100 miles more than doubled between 2016 and 2024. The increase in travel distance appears to be related to a large reduction in admissions to community hospitals with a small number of 2016 admissions, with a corresponding trend towards hospitalizations at a small number of specialty behavioral health hospitals.