Kids in the ER are waiting longer for mental health care – Boston, Massachusetts

Boston, Massachusetts 2021-04-05 00:01:54 –

CChildren taken to the emergency room due to mental health concerns are more likely to stay there for longer stays than they were ten years ago, according to a new study. Hispanic children are almost three times more likely to experience these delays in care than white children.

“Children receiving mental health care every minute, every hour, every day [needs] Spending on ED is a delay in the care they actually need, “said Catherine Nash, author of a study published in pediatrics on Monday.

Nash and her team at Yale University analyzed national survey data from 2005 to 2015, focusing on the length of stay of patients in the emergency room. They found that the proportion of visits that lasted more than 6 hours due to mental health concerns in children increased from about 16% to almost a quarter of the visits. Stays of 12 hours or more increased from 5% to almost 13%.


Researchers don’t know what’s causing the delay, but believe it’s a sign of poor access to proper pediatric mental health care.

Emergency department Not designed Due to mental health emergencies, and in most hospitals, they are also not designed for children. According to Nash, they can have a noisy, chaotic and traumatic experience. Still, it often serves as a gateway to more specialized care for children with mental health problems. The number of adolescents experiencing a mental health crisis has increased over the years, especially during the pandemic.


Due to this surge, children have to wait for understaffed pediatricians to send a doctor or for adults to find an external facility equipped to handle their child’s unique comorbidities and risk factors. The emergency room is a bottleneck because it has to be. .. According to a survey, only 16% of children who come to the emergency room for a mental health visit have seen a mental health provider.

If a child is identified as having a high risk of harming himself or someone else, he or she will not be able to return home safely. These children may need to wait hours or days in the emergency room before seeing a specialist or being transferred to an appropriate psychiatric facility.

“We never have a diabetic child see an endocrinologist and wait a week to start insulin,” said Royceley, a Boston Children’s Hospital doctor who was not involved in the study. “But we have these kids wait a week to take care of what they need.”

Children with violent or dangerous behavior need an experienced health care provider who can keep the child safe and provide the drug at the right time. Lee says he saw the children waiting for mental health care in the emergency room for days at a time.

In general emergency departments, children waiting for mental health treatment also delay the care of other emergency patients who need a bed.

“Use of the emergency department is a valuable resource,” said Polina Class, a physician at the Philadelphia Children’s Hospital, who co-authored the commentary on the study.

For non-white Hispanic children, access barriers are even higher, appearing to be three times more likely than long-term stays. This disparity did not exist in other racial groups, and experts began to question whether the language barrier contributed to delayed care.

“The implications of this work are that there are situations in which we can provide a higher quality transition to final care,” says Klas.

At least some of the solutions to these delays in care could be outside the emergency room, Klas said. Children experiencing acute mental illness can’t wait weeks to see the therapist, but more because they aren’t as urgent as they need to be in the hospital during the night I need a choice. The latest pandemic stimulus, passed by Congress, has allocated funding to develop its own crisis response system as a potential alternative to those who call 911. This will be added to the 3-digit number 988 of the new country connecting to the Crisis Center. For mental health emergencies, which was signed last year.

More descriptive research is needed on the causes behind long-term emergency room stays for children in mental health crisis to produce more solutions, the class said.

“Given that it’s a managed database, you don’t really get into the essential details of the real experience of these kids, teenagers and families,” Lee said.

Nash wants to continue research on the length of stay of pediatric patients and explore interventions that have not yet been tested in the emergency department.

“The mentor once told me to study what makes you angry,” Nash said. “And this is exactly that.”

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