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During the pandemic, the number of kids visiting emergency departments (ED) for mental health issues skyrocketed; the weekly tally of children’s ED visits for suspected suicide attempts rose 39% from 2019 to 2021.
Even though timely follow-up care for self-harm or mental illness has been shown to prevent hospitalizations, reduce the chances of a repeat visit, and improve overall outcomes, less than a third of children receive follow-up care within seven days of their ED visit, and just over half (56%) receive care within a month, according to a recent study from Ann & Robert H. Lurie Children’s Hospital of Chicago. More than a quarter of the children in the study returned to the ED within six months.
“Pediatric ED visits for mental health conditions are rising in the United States, with the majority culminating in discharge,” the study authors wrote. “Timely outpatient follow-up after a mental health ED discharge may facilitate continuity and ongoing engagement in mental health care.”
Avoidable ED visits cost the US healthcare system a pretty penny—especially mental health ED visits.
Patients with commercial health insurance make 18 million avoidable ED visits annually, which adds $32 billion in US healthcare costs, according to a 2019 study from UnitedHealth Group. The biggest driver of those avoidable visits is mental health, with ED visits for mental health issues costing about $4.6 billion annually, according to a 2019 analysis from health services firm Premier.
To conduct the Lurie Children’s study, researchers reviewed records of more than 28,500 children aged 6 to 17 who were enrolled in Medicaid and visited the ED for a mental health episode at least once between January 2018 and June 2019.
They found that Black and Hispanic children were less likely to receive timely follow-ups post-ED visit compared to white children; Black children were about 10% less likely to get a timely follow-up and Hispanic children 3.5% less likely.
The study authors didn’t dive into the causes of the racial disparities, but said they are “consistent with known inequities in receipt of outpatient mental health care.”
“Emergency departments are a really important safety valve,” Robert Cuyler, chief clinical officer at mental health digital therapeutic company Freespira, told Healthcare Brew. “The dilemma is that most emergency departments in this country are not well equipped for dealing with psychiatric emergencies.”