Mental Health Visits Increasing in American Emergency Departments

By James J. Augustine, MD, FACEP

There has been a rapid rise in ED visits related to mental health issues. The latest data on this topic comes from the Centers for Disease Control and Prevention (CDC) and is current through 2016. From the 2016 National Hospital Ambulatory Medical Care Survey report on ED visits from the CDC:

1. There were an estimated 145.6 million ED visits in 2016.
2. There were 5.5 million visits with a primary diagnosis of mental disorder noted in the emergency department.
3. At about 2.4 million visits, a mental health provider saw the patient in the emergency department.
4. About 535,000 visits resulted in hospital admission to the mental health or detoxification unit of their hospital.
5. About 1,130,000 patient visits resulted in transfer to a different hospital with psychiatric capability. Patient visits resulting in admission to some hospital for mental health issues totaled 2,164,000 ED visits, which is about 5,930 patient visits a day.

ED visits; visits by the homeless; visits where a mental health provider saw the patient in the emergency department; and visits where mental health patients were admitted all increased sharply from 2010 to 2016. It seems likely that similar increases continued to occur from 2016 to 2019.

The CDC underestimates the total ED visits in the country. A more comprehensive estimation comes from the National Emergency Department Inventory (NEDI)-USA database, which is maintained by the Emergency Medicine Network at Massachusetts General Hospital in Boston. NEDI-USA contains data on all U.S. EDs open since 2001. According to NEDI-USA, there were 5,381 U.S. EDs and 155,946,509 total U.S. ED visits during the year 2016. All state-specific and national summary NEDI-USA data for the year 2016 can be found here.

Dr. Augustine is director of clinical operations at EMP in Canton, Ohio; clinical associate professor of Emergency Medicine at Wright State University in Dayton, Ohio; vice president of the Emergency Department Benchmarking Alliance; and on the ACEP Board of Directors.