ORLANDO — Pediatric EDs throughout the United States have seen an increase in the number of visits due to mental health problems, according to research presented at the AAP National Conference & Exhibition. Researchers said the rate rose highest among pediatric patients who identified as non-Hispanic black.
Researchers said approximately 17.1 million children in the U.S. have a psychiatric disorder. Furthermore, between 2% and 5% of ED presentations are related to mental health.
Although rates of mental health disorders are increasing throughout the country among children, minority children are less able to gain access to mental health care services compared with nonminority children.
“Mental health disorders are among the most common childhood illnesses,” Anna Abrams, MD, resident physician at Children’s National Health System, told Infectious Diseases in Children. “This research aimed to document the trend of increasing pediatric ED visits for mental health services and to highlight that non-Hispanic black and Hispanic children are disproportionately affected.”
Although mental health-related ED visits have increased among the pediatric population, children who were non-Hispanic black had the greatest increase in these visits, according to research presented at AAP18. The researchers suggest that this is because minority children may have less access to mental health services.
Abrams and colleagues conducted a retrospective cross-sectional study using data collected between 2012 and 2016 from the Pediatric Health Information System. All patients aged 21 years and younger with confirmed mental health diagnoses were included in the study. The researchers assessed the rate of mental health-related ED visits overall and by race or ethnicity using U.S. census data.
During the study period, Abrams and colleagues identified 293,198 visits to pediatric EDs made by patients with mental health diagnoses, with 58,640 presenting annually. Patients had an average age of 13.3 years, and more than half were publicly insured.
Non-Hispanic black patients were more likely to have mental health diagnoses (78.4 per 100,000 population) compared with non-Hispanic white children (51.5 per 100,000 population). Other races that identified as non-Hispanic were also more likely to report higher rates of mental health diagnoses (79.2 per 100,000 population).
Over time, the researchers observed an increase in the number of ED visits made for mental health conditions. In 2012, Abrams and colleagues said the rate was 50.4 per 100,000 population. This number rose to 78.5 in 2016. When the researchers compared the rate at which mental health-related ED visits occurred by race, they observed a more significant increase in non-Hispanic black children compared with non-Hispanic white children.
Abrams said her team plans to explore the reasons for these disparities in care — a topic she describes as “an essential building block to providing children in crisis the help they need when and where they need it.”
“When children and adolescents with mental health disorders lack access to outpatient resources, they often present to pediatric EDs in crisis,” she continued. “Clinicians should routinely screen pediatric patients for mental health issues and make timely referrals to resources. Emergency clinicians should link children and families to mental health resources in their communities for long-term follow-up and care.” – by Katherine Bortz
Abrams A, et al. Racial disparities in pediatric mental health-related ED visits: A 5-year multi-institutional study. Presented at: AAP National Conference & Exhibition; Nov. 2-6, 2018; Orlando, Fla.
Disclosure: Abrams reports no relevant financial disclosures.