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 Between 2011 and 2015, there was a 28 percent increase in
psychiatric emergency department (ED) visits among young people ages
6 to 24, the study found. Visits spiked 54 percent for teens, 53
percent for African-American youth, and 91 percent for young
Hispanic patients.
Suicide-related visits climbed more than two-fold during the study
period.
More than half of these young people were in the ED for at least
three hours. Despite this, only about one in six saw a mental health
care specialist.
"While I am glad the ED is a 24/7 resource, there is a lack of
psychiatric expertise in this setting," said lead study author
Luther Kalb, a researcher at the Kennedy Krieger Institute at Johns
Hopkins University in Baltimore.
"Using the ED as psychiatric crisis center needs to change," Kalb
said by email. "We need to find new ways to get to people in times
of need and where they are at, rather than rely on the ED."
One in ten children, teens and young adults in the U.S. have serious
psychiatric disorders, but many of them never receive treatment,
researchers note in Pediatrics.
As many as seven percent of all pediatric ED visits are related to
mental health or substance abuse.
Often, the emergency room is the only option for youth in crisis who
are experiencing acute problems like suicidal thoughts, aggression
or psychosis, researchers note. It is also where young people go
when they don't have access to a regular mental health care provider
for chronic psychological problems.
For the current study, researchers examined nationally
representative data on ED visits in the U.S. to estimate what
proportion were related to mental health issues for young people.
Teens and young adults were more than four times more likely than
children to have psychiatric ED visits, the study found.
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The probability of psychiatric ED visits for young children didn't
change during the study period, even as it increased for teens and
young adults.
The study wasn't a controlled experiment designed to find
explanations for why more young people are visiting EDs with
psychiatric problems.
Even so, it adds to earlier research suggesting that mental health
disorders including depression and anxiety are rising among children
and young adults, said Dr. Susan Duffy, a professor at the Alpert
Medical School of Brown University and a pediatric emergency
physician at Hasbro Children's Hospital in Providence, Rhode Island.
"The take home message for parents is to understand that mental
health problems are common in otherwise healthy youth and in some
children are the result of chronic stressors, particularly anxiety
and depression," Duffy, co-author of an accompanying editorial, said
by email.
As in other medical conditions, she added, "there are recognizable
signs and symptoms, including change in behavior, isolation, lack of
motivation, sadness, poor appetite and sleep, angry outbursts or
agitated behavior that may be manifested in school failure and
difficulty with relationships."
"Parents should be aware that suicidal thoughts are common in youth
and often go unreported unless directly questioned and that a
significant proportion of youth who successfully complete suicide
have not received mental health care."
SOURCE: http://bit.ly/2CsI62S Pediatrics, online March 18, 2019.
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