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Pediatric mental health emergency department visits from 2017 to 2022: A multicenter study.

Authors :
Hoffmann JA
Carter CP
Olsen CS
Ashby D
Bouvay KL
Duffy SJ
Chamberlain JM
Chaudhary SS
Glomb NW
Grupp-Phelan J
Haasz M
O'Donnell EP
Saidinejad M
Shihabuddin BS
Tzimenatos L
Uspal NG
Zorc JJ
Cook LJ
Alpern ER
Source :
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine [Acad Emerg Med] 2024 Aug; Vol. 31 (8), pp. 739-754. Date of Electronic Publication: 2024 Apr 02.
Publication Year :
2024

Abstract

Background: The COVID-19 pandemic adversely affected children's mental health (MH) and changed patterns of MH emergency department (ED) utilization. Our objective was to assess how pediatric MH ED visits during the COVID-19 pandemic differed from expected prepandemic trends.<br />Methods: We retrospectively studied MH ED visits by children 5 to <18 years old at nine U.S. hospitals participating in the Pediatric Emergency Care Applied Research Network Registry from 2017 to 2022. We described visit length by time period: prepandemic (January 2017-February 2020), early pandemic (March 2020-December 2020), midpandemic (2021), and late pandemic (2022). We estimated expected visit rates from prepandemic data using multivariable Poisson regression models. We calculated rate ratios (RRs) of observed to expected visits per 30 days during each pandemic time period, overall and by sociodemographic and clinical characteristics.<br />Results: We identified 175,979 pediatric MH ED visits. Visit length exceeded 12 h for 7.3% prepandemic, 8.4% early pandemic, 15.0% midpandemic, and 19.2% late pandemic visits. During the early pandemic, observed visits per 30 days decreased relative to expected rates (RR 0.80, 95% confidence interval [CI] 0.78-0.84), were similar to expected rates during the midpandemic (RR 1.01, 95% CI 0.96-1.07), and then decreased below expected rates during the late pandemic (RR 0.92, 95% CI 0.86-0.98). During the late pandemic, visit rates were higher than expected for females (RR 1.10, 95% CI 1.02-1.20) and for bipolar disorders (RR 1.83, 95% CI 1.38-2.75), schizophrenia spectrum disorders (RR 1.55, 95% CI 1.10-2.59), and substance-related and addictive disorders (RR 1.50, 95% CI 1.18-2.05).<br />Conclusions: During the late pandemic, pediatric MH ED visits decreased below expected rates; however, visits by females and for specific conditions remained elevated, indicating a need for increased attention to these groups. Prolonged ED visit lengths may reflect inadequate availability of MH services.<br /> (© 2024 The Authors. Academic Emergency Medicine published by Wiley Periodicals LLC on behalf of Society for Academic Emergency Medicine.)

Details

Language :
English
ISSN :
1553-2712
Volume :
31
Issue :
8
Database :
MEDLINE
Journal :
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
Publication Type :
Academic Journal
Accession number :
38563444
Full Text :
https://doi.org/10.1111/acem.14910