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Study finds surge in children seeking emergency mental health treatment

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The number of American children admitted to hospital emergency rooms with emotional problems has been surging in recent years, according to a new study.

In a study published Tuesday in JAMA Pediatrics, seven public health researchers reported that the number of kids visiting 38 pediatric mental health emergency departments increased annually by 8% from Oct. 1, 2015, to Feb. 29, 2020 — far outpacing the 1.5% yearly increase for all other visits.

Among 308,264 mental health emergency room visits from 217,865 unique patients during that time, 13.2% of patients “revisited” with another crisis within 6 months, the researchers reported.

“When kids come back to the emergency department multiple times for mental health reasons, it is a sign that we, as a healthcare system, are not giving them adequate care,” lead researcher Dr. Anna Cushing, an emergency room pediatrician at Children’s Hospital Los Angeles, said in an email.

Children with psychotic disorders, disruptive or impulse control disorders and neurodevelopmental disorders proved likeliest to return to emergency rooms, according to the study.

From 2007 to 2016, the study found pediatric mental health emergency department visits increased by more than 60% at all hospitals and more than 120% at children’s hospitals.

These results are “in line with other studies” that have shown the number of emotionally troubled children increasing nationally, Dr. Cushing noted.

“These surges are likely due to a combination of worsening mental health disease in children and limited availability of outpatient pediatric mental health providers, which leads children to come to the emergency department when they need care,” she said.

The rates of children seeking mental health treatment in emergency rooms have risen even faster since pandemic lockdowns shuttered schools and forced students into virtual learning, recent studies show.

A study published Dec. 13 in JAMA Network Open found the number of children ages 11 to 17 hospitalized for severe anxiety, depression and suicide risk rose 14% during the pandemic — from 9,696 in the 14 months through March 2020 to 11,101 in the following 13 months.

“The number of children who have sought care for mental health-related issues since March 2020 has been staggering,” Dr. Chris A. Rees, a pediatrician and researcher at Emory University School of Medicine, said in an email.

Last year, the American Academy of Pediatrics, the Children’s Hospital Association and the American Academy of Child and Adolescent Psychiatry jointly declared a National State of Emergency in Children’s Mental Health.

In November, the Department of Health and Human Services issued new national guidelines to improve mental health crisis care for children. They promote alternatives to emergency room care, including the 988 Suicide & Crisis Lifeline, for families with limited resources. 

“America’s youth deserve appropriate, well-informed and effective behavioral health crisis services,” Miriam E. Delphin-Rittmon, HHS assistant secretary for mental health and substance use, told The Washington Times on Tuesday.

Added Ms. Delphin-Rittmon: “All too often, children and youth experiencing a behavioral health crisis face hospitalization or justice system involvement instead of receiving the home-based care and community-based services that are in many circumstances best for de-escalating and stabilizing a crisis.”

The 988 Lifeline answered 141,032 more calls in October than during the same month last year, according to the latest report from HHS’ Substance Abuse and Mental Health Services Administration. About 80% of the latest calls and texts came from people younger than 25.

Suicide is “the only substantial cause of death during childhood that is grounded in mental illness,” said social psychologist Brett Pelham, a professor at Montgomery College in Maryland.

He pointed out in an email that figures from the Centers for Disease Control and Prevention show childhood suicides rose during the same years covered in Tuesday’s JAMA Pediatrics study.

“There was a modest increase, of about 18%, in childhood suicide rates between the specific period 2015-2020,” Mr. Pelham said.

Negative social media influences, divisive politics and racial tensions likely contributed to emergency room surges during those years, said clinical psychologist Thomas Plante, a member of the American Psychological Association.

Increases in childhood anxiety, depression, addictions and suicide risks have accelerated since COVID lockdowns started, the Santa Clara University professor added in an email. And he said families are not getting the support they need to cope with stressors like rising gun violence.

“We’ll have to see what the updated data tells us, but we should brace ourselves for bad news,” Mr. Plante said. “Our society is in deep trouble. Mental health issues, especially among youth, are exploding.”



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