Mental Health Visits: Examining Socio-demographic and Diagnosis Trends in the Emergency Department by the Pediatric Population

Abstract

The emergency department (ED) is increasingly being used for mental health visits by children and adolescents. It is estimated that 21-23% of youth have a diagnosable psychiatric or substance use disorder. Using data from the ED of a tertiary medical center, we examined trends in mental health diagnoses over a 5-year period. In school age children the most prevalent diagnoses were anxiety disorders (28.4%); disorders first usually diagnosed in infancy, childhood, or adolescence (26.5%), and mood disorders (18.6%). High school students were more likely to visit the ED for anxiety disorders (30%). Females (34.5%) presented more for anxiety disorders compared to males (22.7%). Mental health visits and diagnoses were higher during school months (September-May) and lower in the summer months (June-August). The diagnosis trends identified in this study have clinical implications that can contribute to evidence-based restructuring of mental health resources and screenings.

Evaluation of Psychotropic Drug Use in Adolescents Accessing a General Emergency Medical Department for Mental Disorders

“…Overall, four out of 100 accesses to the ED by adolescents occurred for psychiatric reasons, a figure consistent with the rate of 1-5% paediatric ED accesses observed in previous international studies [5][6][7][8][9].…”

“…The emergency department (ED) has become an important gateway for access to mental health services for children and youth due to limited access and long waiting times for specialized assessment and services [3,4]. Both international and Italian studies show that ED visits for mental health disorders account for 1% to 5% of pediatric emergency visits [5][6][7][8][9]. Moreover, from 70% to 84% of individuals presenting to pediatric emergency mental health services are adolescents, and mostly females [7,[10][11][12].…”

“…Both international and Italian studies show that ED visits for mental health disorders account for 1% to 5% of pediatric emergency visits [5][6][7][8][9]. Moreover, from 70% to 84% of individuals presenting to pediatric emergency mental health services are adolescents, and mostly females [7,[10][11][12]. Studies focusing on adolescents accessing the ED for psychiatric disorders reported mood disorders (9-63%), agitation (21-33%), and anxiety (5-21%) as the most common diagnosis at discharge [10][11][12].…”

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

“…As expected, the duration of hospitalization tends to be longer for those who are admitted via the Emergency Department, with a duration of just under a month. As a matter of fact, these cases are more serious and require a longer period for clinical stabilization, as studies on access to pediatric emergency departments report [ 8 , 9 ]; more complex cases also often require longer times for the definition of a post discharge care plan: because they involve a multidisciplinary team, such treatment plans require the collaboration of a greater number of health services and more organizational steps.…”

“…Furthermore, suicide constitutes the third leading cause of death among adolescents [ 6 ]. In this age group, acute psychiatric conditions are the main cause of admission to mental healthcare services [ 2 , 7 , 8 , 9 , 10 , 11 ].…”