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The Great Surge in Pediatric Mental Health Emergencies

By Joyce Li, MD; Vera Feuer, MD; and Mohsen Saidinejad, MD | on November 6, 2023 | 0 Comment
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As EDs continue to struggle to keep up with the great surge of pediatric mental-health emergencies, especially prolonged boarding, a new, joint, policy statement by ACEP, American Academy of Pediatrics, and Emergency Nurses Association on management of pediatric mental health in the ED was recently published online and appears in the September 2023 issues of the Annals of Emergency Medicine, the Journal of Emergency Nursing, and Pediatrics.24-26

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Explore This Issue
ACEP Now: Vol 42 – No 11 – November 2023

Dr. Li is an assistant professor in pediatrics and emergency medicine at Harvard Medical School and a pediatric emergency medicine physician at Boston Children’s Hospital, both in Boston.

Dr. Feuer is associate vice president of school mental health and director of pediatric emergency psychiatry at Northwell Health, Cohen Children’s Medical Center. She is also an associate professor of psychiatry, pediatrics and emergency medicine at the Zucker School of Medicine at Hofstra/Northwell Health, NY.

Dr. Saidinejad is a professor of emergency medicine and pediatrics at the David Geffen School of Medicine, and director of pediatric emergency medicine at the University of California, Los Angeles.

References

  1. Piao J, Huang Y, Han C, et al. Alarming changes in the global burden of mental disorders in children and adolescents from 1990 to 2019: a systematic analysis for the Global Burden of Disease study. Eur Child Adolesc Psychiatry. 2022;31(11):1827-1845.
  2. Shankar LG, Habich M, Rosenman M, et al. Mental health emergency department visits by children before and during the COVID-19 pandemic. Acad Pediatr. 2022;22(7):1127-1132.
  3. Radhakrishnan L, Leeb RT, Bitsko RH, et al. Pediatric emergency department visits associated with mental health conditions before and during the COVID-19 pandemic – United States, January 2019-January 2022. MMWR Morb Mortal Wkly Rep. 2022;71(8):319-324.
  4. Hoffmann JA, Alegría M, Alvarez K, et al. Disparities in pediatric mental and behavioral health conditions. Pediatrics. 2022;150(4):e2022058227.
  5. American Academy of Pediatrics. AAP-AACAPCHA Declaration of a National Emergency in Child and Adolescent Mental Health. AAP website. Updated October 19, 2021. Accessed October 11, 2023.
  6. Manuel MM, Yen K, Feng SY, et al. The burden of mental and behavioral health visits to the pediatric ED: A 3-year tertiary care center experience. Child Adolesc Ment Health. 2023;28(4):488-496.
  7. Wolff JC, Maron M, Chou T, et al. Experiences of child and adolescent psychiatric patients boarding in the emergency department from staff perspectives: Patient journey mapping. Adm Policy Ment Health. 2023;50(3):417-426.
  8. Miller, G, Enguidanos, E. Emergency departments and the growing mental health crisis. ACEP Now website. Published May 2, 2023. Accessed October 11, 2023.
  9. Randall MM, Parlette K, Reibling E, et al. Young children with psychiatric complaints in the pediatric emergency department. Am J Emerg Med. 2021;46:344-348.
  10. National Institute of Mental Health. Ask suicide screening questions (ASQ). NIMH website (OMB approval #0925-0648). Expiration date June 30, 2024. Accessed October 11, 2023.
  11. Columbia Lighthouse Project. Columbia suicide severity rating scale (C-SSRS). Columbia Lighthouse website. Published 2016. Accessed October 11, 2023.
  12. Columbia Lighthouse Project. Columbia Suicide Screening Rating Scale (C-SSRS) – screen for triage points for primary care. University of Washington Psychiatry & Behavioral Health Sciences Division of Population Health website. Accessed October 11, 2023.
  13. Marzola E, Duranti E, De-Bacco C, et al. Psychiatric patients at the emergency department: factors associated with length of stay and likelihood of hospitalization. Intern Emerg Med. 2022;17(3):845-855.
  14. Cushing AM, Liberman DB, Pham PK, et al. Mental health revisits at us pediatric emergency departments. JAMA Pediatr. 2023;177(2):168-176.
  15. Hoffmann JA, Krass P, Rodean J, et al. Follow-up after pediatric mental health emergency visits. Pediatrics. 2023;151(3):e2022057383.
  16. Bardach NS, Doupnik SK, Rodean J, et al. ED visits and readmissions after follow-up for mental health hospitalization. Pediatrics. 2020;145(6):e20192872.
  17. Stanley B, Brown G. Stanley-Brown safety planning intervention. Stanley-Brown website. Accessed October 11, 2023.
  18. Harvard University TH Chan School of Public Health. Means Matter. Harvard University website. Copyright 2023. Accessed October 11, 2023.
  19. Emergency Medical Services for Children Innovation and Improvement Center. Pediatric education and advocacy kits (PEAK): Suicide. EIIC website. https://emscimprovement.center/education-and-resources/peak/pediatric-suicide-screening-mental-health/. Accessed October 11, 2023.
  20. Emergency Medical Services for Children Innovation and Improvement Center. Pediatric education and advocacy kits (PEAK): Agitation. EIIC website. https://emscimprovement.center/education-and-resources/peak/pediatric-agitation/. Accessed October 11, 2023.
  21. Feuer V, Mooneyham GC, Malas NM. Addressing the pediatric mental health crisis in emergency departments in US: Findings of a national pediatric boarding consensus panel. J Acad Consult Liaison Psychiatry. 2023:S2667-2960(23)00089-7.
  22. Emergency Medical Services for Children Innovation and Improvement Center. New England Regional Behavioral Toolkit. EIIC website. https://emscimprovement.center/state-organizations/new-england/new-england-behavioral-health-toolkit/. Published June 2021. Accessed October 11, 2023.
  23. Pulcini CD, Schneider S, Wolfley H, Collins B, Li J. Assessment of statewide initiative for children boarding in rural emergency departments with mental health concerns. Acad Emerg Med. 2023. doi: 10.1111/acem.14772. Epub ahead of print.
  24. Saidinejad M, Duffy S, Wallin D, et al. The management of children and youth with pediatric mental and behavioral health emergencies. Pediatrics. 2023:1;152(3):e2023063256.
  25. Saidinejad M, Duffy S, Wallin D, et al. The management of children and youth with pediatric mental and behavioral health emergencies. J Emerg Nurs. 49(5):703-713.
  26. Saidinejad M, Duffy S, Wallin D, et al. The management of children and youth with pediatric mental and behavioral health emergencies. Ann Emerg Med. 2023;82(3):e97-105.

Pages: 1 2 3 4 | Single Page

Topics: ClinicalMental HealthPediatricsPsychiatric

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