30 Aug The Concerning Trend in Pediatric Behavioral Health Emergency Room Visits

Medical professionals and public health officials across the United States are expressing concern about the growing rise of youth behavioral health visits in our nation’s hospitals. While alarming, this trend should come as no surprise given the ongoing youth mental health crisis that the COVID-19 pandemic has further exacerbated.

In December 2021, US Surgeon General Dr. Vivek Murthy issued an official advisory to highlight the “pandemic’s unprecedented impacts on the mental health of America’s youth and families, as well as the mental health challenges that existed long before the pandemic.” He then called for a “swift and coordinated response to this crisis as the nation continues to battle the COVID-19 pandemic.”

In the months since that advisory was issued, great strides have been made to address the pediatric mental health crisis and provide resources to youth and their families seeking care. Despite that, many children and adolescents in America still don’t have access to safe and affordable mental health care.

As a result, various factors including inaccessibility, stigmatization, and the lack of healthy coping strategies have turned emergency departments into the primary point of care for children’s mental health emergencies.

Youth Behavioral Health Hospital Visits: By the Numbers

It’s easy to see how grave this mental health crisis has become by looking at national numbers for youth behavioral health emergency visits. 

In one February 2022 research study published in the Morbidity and Mortality Weekly Report (MMWR), researchers found significant increases in the number of emergency room visits by adolescent females (aged 12 to 17 years) for a variety of mental health conditions, including:

• Eating disorders (approximately 145 visits per week in 2021, up from 94 in 2020)
• Depression (approximately ​​2,834 visits per week in 2021, up from 2,132 in 2020) 
• Obsessive-compulsive disorder (approximately 59 visits per week in 2021, up from 49 in 2020) 
• Anxiety (approximately 2,194 visits per week in 2021, up from 1,794 in 2020) 
• Trauma and stressor-related conditions (approximately 817 visits per week in 2021, up from 646 in 2020) 

 
Additionally, one regional study of hospitals in New Jersey found that mental health conditions among teens aged 12 to 17 were driving a noticeable increase in emergency room visits during the pandemic. NJHA’s Center for Health Analytics, Research and Transformation (CHART)  researchers found:

• The proportion of depression-related hospital visits for youth increased 25% from 2019 (the last pre-pandemic year) to 2021.
• Depression was the most frequently diagnosed mental health condition among youth ages 12 to 17.
• Self-harm cases resulting in hospital admission rose 95% from 2019 to 2021.
• Inpatient admissions for youth with anxiety increased 54% from 2019 to 2021.

 
Like the MMWR study, researchers at the NJHA also found that eating disorder-related hospitalizations for adolescent females were roughly 2.5 times higher in 2021 than in pre-pandemic years. 

Increasing Access to Care for Youth in Your Community

Many mental health clinicians are worried about the growing trend of youth behavioral health emergency room visits. However, with so many other external factors in play, it’s hard for professionals to recognize how they can help. Here are some resources and ideas for mental health clinicians to use in their clinics to help encourage improved outcomes and accessibility for the youth in their care. 

Share resources with your client population. Mental health professionals are typically well-placed to access resources from organizations like the CDC, the Substance Abuse and Mental Health Services Administration (SAMHSA), and other academic and professional healthcare associations. Often, the best thing you can do for the clients in your care is share these resources widely. Whether you send periodic emails, post on social media, or display flyers and posters in your office, sharing this helpful content can make it easier for your clients and their families to find.

Empower the youth in your care with healthy coping mechanisms. If you are already working with children and adolescents, your clients are lucky to have you! One of the best ways to help them avoid emergency room visits is to work with them to develop healthy coping strategies. Developing these coping strategies and improving resiliency were both identified in the MMWR study as critical to improving national youth mental health. 

Ensure your behavioral health clinic is fully staffed. A 2022 National Council for Mental Wellbeing survey found that 67% of adults had more difficulty finding a mental health care provider than they did finding a health care provider for their physical health needs. Among those who were able to access care, 23% reached out to more than one provider before they found one that was accepting new clients.  

Even though the pandemic has put unprecedented pressure on mental and behavioral health clinicians, making sure that your clinic is fully staffed with as many providers as possible is crucial to expanding your access to your services. This ensures you can continue serving the needs of the youth in your care, as well as those that will come seeking it.  

Integrate with local pediatric and primary care providers. One of the best evidence-based care models shown to improve clinical outcomes for youth mental health is pediatric integrated mental health care. By working closely with pediatricians and other primary care providers, behavioral health clinicians can help ensure that the mental health needs of their clients are being addressed and no symptoms or issues are slipping through the cracks.

Recently, the American Rescue Plan Act opened up more avenues of funding to encourage behavioral health integration into pediatric primary care. Exploring these grants may help provide your clinic with the resources necessary to better integrate with local pediatric providers.   

More Great Resources

Mental health clinicians are the key component to making a difference in the ongoing crisis in pediatric behavioral health. To help you stay informed on the latest trends and data on this topic, check out some of our favorite resources.

What Should I Do?: A Mental Health Resource for Parents

Information on American Rescue Plan Act Funding for Pediatric Mental Health Care Access

Pediatric Integrated Care Resource Center

SAMHSA National Guidelines for Behavioral Health Crisis Care