Dealing with mental health in the pediatric emergency department

McCollum, Danielle; Beattie, Tom F.

doi:10.1097/mej.0000000000000822

Cited by 2 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This has resulted in prolonged ED wait times and delay in appropriate care and disposition (Lee, Black, Meckler, & Doan, 2020; Tolentino, Symington, Jordan, Kinnear, & Jarvis, 2021). Furthermore, similar strategies have been utilized outside the USA to mitigate against prolonged EDLOS, which include, strong collaborations with mental health teams to provide comprehensive and quality care to children visiting with MBH challenges (McCollum & Beattie, 2021). Other promising solutions to improve access to care and reduce admission rate and length of stay is the use of telehealth for psychiatric consultation.…”

Section: Discussionmentioning

confidence: 99%

The burden of mental and behavioral health visits to the pediatric ED: A 3‐year tertiary care center experience

Manuel

Yen

Feng

et al. 2023

Child Adoles Ment Health

View full text Add to dashboard Cite

BackgroundThe shortage of mental health services across the United States has turned pediatric emergency departments (PEDs) into safety‐nets for the increasing population of children with mental and behavioral health (MBH) needs. This study provides a descriptive characterization of MBH‐related PED visits, the trends in visit, ED length of stay (EDLOS), and admission rate.MethodsWe reviewed electronic health records of children ≤18 years with MBH needs, who visited the PED of a large tertiary hospital from January 2017 to December 2019. We performed descriptive statistics, chi‐square (χ2), and logistic regression analyses to evaluate trend in visit, EDLOS, admission rate, and predictors of prolonged EDLOS and inpatient admission.ResultsOf 10,167 patients, 58.4% were females, median age was 13.8 years, and 86.1% were adolescents. On average, visits increased by 19.7% annually, with a 43.3% increase over 3 years. Common ED diagnoses include, suicidality (56.2%), depression (33.5%), overdose/poisoning, and substance use (18.8%), and agitation/aggression (10.7%). Median EDLOS was 5.3 hr, average admission rate was 26.3%, with 20.7% boarding in the ED for >10 hr. Independent predictors of admission include depression (pOR: 1.5, CI: 1.3–1.7), bipolar disorder (pOR: 3.5, CI: 2.4–5.1), overdose/substance use disorder (pOR: 4.7, CI: 4.0–5.6), psychosis (pOR: 3.3, CI: 1.5–7.3), agitation/aggression (pOR: 1.8, CI: 1.5–2.1), and ADHD (pOR: 2.5, CI: 2.0–3.0). Principal independent driver of prolonged EDLOS was patient admission/transfer status (pOR: 5.3, CI: 4.6–6.1).ConclusionsGiven the study results, MBH‐related PED visits, ED length‐of‐stay, and admission rates continue to rise even in recent years. PEDs lack the resources and capability to provide high‐quality care for the increasing population of children with MBH needs. Novel collaborative approaches and strategies are urgently needed to find lasting solutions.

show abstract

Section: Discussionmentioning

confidence: 99%

The burden of mental and behavioral health visits to the pediatric ED: A 3‐year tertiary care center experience

Manuel

Yen

Feng

et al. 2023

Child Adoles Ment Health

View full text Add to dashboard Cite

show abstract

From Their Perspective

Lapsa,

O'Donnell,

Yanek

et al. 2024

Pediatr Emer Care

View full text Add to dashboard Cite

Background The pediatric emergency department (PED) is experiencing a rising volume of patients with mental health concerns, leading to prolonged boarding times and delays in initiating active therapeutic plans. A paucity of research exists for the self-reported pediatric patient experience during such boarding. Objectives To inform more individualized and patient-centered PED care for patients boarding for mental health admission, by learning the prior trauma experiences and patient perspective on prolonged PED mental health stays. Methods A convenience sample was collected at an urban hospital's PED among those boarding for mental health emergency greater than 24 hours. Demographic information, exposures to past trauma, and perceptions on and understanding of their care experience, were discussed. Descriptive and thematic content analysis were used for data analysis. Results A total of 99 youths were included in the study and the majority reported worsening mental health symptoms during PED boarding, notably increasing anxiety (72 [72.7%]). Patients were equivocal on efficacy of PED mental health intake on symptoms (41 [41.4%]). Personal suggestions were offered by these patients to guide the care of future children that would better mitigate their symptoms while boarding in the PED, such as group activities, electronics, and physical activity. Discussion Patients in mental health crisis boarding in the PED have already experienced stressful life events. By listening to the personal stories of this vulnerable population, the PED can improve care delivery and design a more therapeutic environment, especially as the need for acute mental health management continues to increase.

show abstract

Dealing with mental health in the pediatric emergency department

Cited by 2 publications

References 12 publications

The burden of mental and behavioral health visits to the pediatric ED: A 3‐year tertiary care center experience

The burden of mental and behavioral health visits to the pediatric ED: A 3‐year tertiary care center experience

From Their Perspective

Contact Info

Product

Resources

About