Child Mental Health Services in the Emergency Department

Lynch, Seán; Bautista, María A.; Freer, Cecilia; Kalynych, Colleen; Hendry, Phyllis L.

doi:10.1097/pec.0000000000000336

Cited by 15 publications

(8 citation statements)

References 21 publications

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“…Increased use of the ED has previously been observed in the Medicaid population. [18][19][20] Although this study was not designed to compare Medicaid versus private insurance, our results confirm that the ED is frequently used by the Medicaid population.…”

Section: Discussionsupporting

confidence: 72%

Hospital Admission and Emergency Department Utilization in an Infant Medicaid Population

Paul

Agiro

Hoffman

et al. 2016

Hospital Pediatrics

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A B S T R A C T BACKGROUND AND OBJECTIVE:In the first year of life, the rate of rehospitalization for infants has been shown to be between 4.4% and 9.5%. Reducing avoidable health care utilization is a population health priority. The goal of this study was to identify maternal and infant factors associated with rehospitalization and emergency department (ED) utilization in a cohort of newborn Medicaid recipients. METHODS:A longitudinal database was created by linking mother-infant dyads giving birth at a regional perinatal referral center with Delaware state Medicaid data. Multivariable logistic regression and negative binomial regression were used to examine inpatient hospitalization and ED utilization within 6 months after birth. RESULTS:The study cohort included 4112 infants; 452 (11.0%) were rehospitalized, and 1680 (41%) used the CONCLUSIONS:In this newborn Medicaid population, multiple maternal factors (including age, race, and mental health diagnoses) were associated with health care utilization in the 6 months after initial hospital discharge. Our data provide potential risk factors for targeted intervention and suggest that maternal factors should be considered in identifying a population at risk for rehospitalization and ED utilization.

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Section: Discussionsupporting

confidence: 72%

Hospital Admission and Emergency Department Utilization in an Infant Medicaid Population

Paul

Agiro

Hoffman

et al. 2016

Hospital Pediatrics

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“…In the literature, little information emerges regarding hospitalization trends [ 13 ]. Nonetheless, the demographic and clinical factors most associated with psychiatric hospitalizations during child development appear to be adolescence, suicidal ideation and/or suicide attempts (more frequent among females), psychomotor agitation (more frequent among males), a psychiatric family history, past hospitalizations, psychiatric comorbidity, a history of victimization (bullying, physical, psychological, and/or sexual abuse, neglect, and witnessing violence), and academic and relational difficulties [ 2 , 7 , 14 , 15 , 16 , 17 , 18 ]. In particular, a large number of studies identify parental psychiatric illness as one of the most significant risk factors for pediatric-age psychiatric hospitalization [ 16 , 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit

et al. 2021

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The past twenty years have seen a rapid increase in acute psychiatric symptoms in children and adolescents, with a subsequent rise in the number of psychiatric hospitalizations. This paper aims to: (a) describe the epidemiology of hospitalizations and some of the clinical and sociodemographic characteristics of pediatric patients admitted to a regional referral Complex Operative Child Neuropsychiatry Hospital Unit in Northeast Italy and (b) identify potential factors correlated with the length of hospital stay. Methods: 318 (M = 12.8 years; SD = 3.11; 72% Female) patients hospitalized for mental health disorders from 2013 to 2019. Results: Around 60% of hospital admissions occurred via the emergency room, mostly due to suicidal ideation and/or suicide attempts (24%). Affective disorders were the most frequent discharge diagnosis (40%). As for factors correlated with length of hospital stay, we found significant links with chronological age, way of hospital admission, cause of admission, discharge diagnosis, presence of psychiatric comorbidity, family conflict, and psychiatric family history. Conclusions: These results provide information about global characteristics associated with the length of psychiatric hospital stays in pediatric patients and provide a basis on which specific precautions can be hypothesized with the aim of developing more focused treatments.

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“…The previous literature on mental health ED visits highlight specific categories like suicide, mood disorders, behavioral disorders, and substance use/abuse, but few have provided a current in-depth assessment of mental health categories especially within pediatric and American Indian populations. 10, 16, 25 We found that the depressive disorder category was most common for older American Indian children. Similar to our results, one previous study found that adjustment disorders as well as post-traumatic stress disorder were common among urban American Indian and Alaska Native Youth receiving mental health services.…”

Section: Discussionmentioning

confidence: 68%

“…Other studies have found lower prevalence for younger children as well. 7, 25 The reason for this difference is unclear, but we hypothesize that the mental health conditions are present but are not being recognized or screened properly. We also believe this is exacerbated for American Indian children due to differential access to mental health providers and financial constraints.…”

Section: Discussionmentioning

confidence: 96%

Emergency Department Utilization for Mental Health in American Indian Children

Pickner

Puumala

Chaudhary

et al. 2016

The Journal of Pediatrics

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Objectives To examine emergency department (ED) visits for mental health concerns by American Indian children in a multi-center cohort. To analyze demographic and clinical factors, the types of MH concerns and repeat mental health visits. Study design Cross-sectional study of children 5 to 18 years old who visited one of six EDs in the Upper Midwest from June 2011 to May 2012 and self-identified as White or American Indian. Mental health visits were identified by primary diagnosis and reasons for visit and were categorized into diagnostic groups. We explored racial differences in ED visits for mental health, diagnostic groups, and repeat mental health visits. Analysis involved Chi-squared tests, Cochran–Mantel–Haenszel tests, and regression models including age, triage, timing, and insurance and their interactions with race. Results We identified 26,004 visits with 1545 (5.94%) for mental health. The proportion of visits for mental health differed by race and age. American Indian children had lower odds of a mental health visit for 5–10 year olds (Odds Ratio (OR) =0.40, 95% Confidence Interval (CI) =0.26–0.60), but higher odds for 11–17 year olds (OR=1.62, 95% CI = 1.34–1.95). In the older age group, American Indian children were primarily seen for depression and trauma- and stressor-related disorders, whereas White children were primarily seen for depression and disruptive, impulse-control, and conduct disorders. Repeat visits were not different by race. Conclusion Differences were noted in mental health visits between American Indian and White children and were influenced by age. These findings warrant further investigation into care seeking patterns and treatment for mental health in American Indian children.

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Child Mental Health Services in the Emergency Department

Abstract: The ED is an entry point into the child mental health system of care for children with Medicaid.

Cited by 15 publications

References 21 publications

Hospital Admission and Emergency Department Utilization in an Infant Medicaid Population

Hospital Admission and Emergency Department Utilization in an Infant Medicaid Population

A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit

Emergency Department Utilization for Mental Health in American Indian Children

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