Objective:
To analyze the characteristics of pediatric mental health-related and suicide-related emergency department visits in relation to the volume of pediatric visits at the ED.
Approach:
- Study Design: Retrospective cross-sectional exploratory study using the 2016 to 2022 Nationwide Emergency Department Sample (NEDS).
- Population: Pediatric patients aged 5 to 17 years with a primary mental health diagnosis.
- Data Analysis: Included approximately 5.4 million weighted mental health-related ED visits, with multivariable analyses examining associations with various demographic and clinical factors.
Key Findings:
- 50% of pediatric mental health-related ED visits occurred at high-volume EDs, while the other 50% were at lower-volume EDs, including 5% at low-volume EDs, 21% at medium-volume EDs, and 24% at medium-high-volume EDs.
- Patients aged 15 to 17 years accounted for 49% of visits, with 58% involving female patients.
- Suicide or self-injury was the most frequent diagnosis at 24%, followed by depressive disorders at 23%.
- Mental health-related ED visits increased by 24% from 2016 to 2022, while suicide-related visits increased by 74%.
- Non-Hispanic Black and Hispanic patients had higher odds of presenting to high-volume EDs compared to non-Hispanic White patients.
Interpretation:
The study highlights that a significant proportion of pediatric mental health-related and suicide-related visits occur in lower-volume EDs, which may lack adequate mental health resources.
Limitations:
- NEDS does not include patient-level identifiers, limiting the ability to account for patient-level clustering.
- Administrative coding may have misclassified demographic characteristics and diagnoses.
- Race and ethnicity data were unavailable for nearly half of the study period, which may affect the generalizability of the findings.
- Data did not capture adverse childhood experiences or neighborhood-level factors.
Conclusion:
The findings indicate that approximately half of pediatric mental health-related and suicide-related ED visits occur outside high-volume pediatric EDs, with variations based on race, ethnicity, and diagnosis.
Sources:
This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.
