Addressing the Mental Health of Children Before Reaching the ED

Summary of Addressing Mental Health Needs in Children Before They Reach the ED published to Behavioral Healthcare Executive on February 20, 2020.

Hospital emergency departments (EDs) across the country have been increasingly experiencing large numbers of children and teens in need of treatment for their mental health issues.

It is a clear indicator that children are far from close to receiving the treatment they need for their mental health issues before reaching a critical state. We also can see their is a lapse in oversight of our youth. Based on clear analysis from the Behavioral Healthcare Executive:

In Colorado, 25% of ED visits by children and teens in 2018 were mental health-related, an increase of 4% in two years, a recent report found. What is more shocking is that the percentage doesn’t include juveniles who present with a secondary diagnosis related to mental health or whose conditions involve substance abuse.


But EDs are ill-prepared to treat youth who struggle with mental health challenges. They typically lack the specialized expertise to properly diagnose and assess treatment options for adolescents in mental health distress. Even when children with anxiety and depression are properly identified, a shortage of behavioral health specialists means kids may not get the help they need in a timely fashion, especially if they live in rural areas or are economically disadvantaged. The impact: repeat ED visits by teens for mental health challenges and high rates of ED-to-inpatient admissions.


Behind the numbers | Recent data point to the complexities of treating mental health issues among youth who present in the ED:

  • Major depressive disorder was the most common diagnosis among youth 18 and younger in Colorado, according to a three-year review of commercial, Medicare and Medicaid claims.

  • Nearly 60% of mental health-related ED visits among teens and young adults in California involve self-harm.

  • Teens who come to the ED with self-harm injuries face increased risk for repeat ED visits for self-harm or suicide attempts and are eight times more likely to die from suicide. They are also three times as likely to die within five years of any cause, one study shows.

  • Rising rates of mental health ED visits among kids in California correspond with higher rates of suicide among teens and young adults.

Given the number of children and teens who attempt suicide and the increased violence by which suicides occur, it’s clear that health professionals must work to pair youth with the right resources when they present in the ED with a mental health condition. But without mental health training, ED professionals often face challenges accurately diagnosing a child’s condition.

Read more from Behavioral Health Executive. They make a clear case on where to go from here, how to establish new protocols for EDs across the nation, and how we can ensure our youth are better protected and treated.

Summary analysis by Taylor Weyeneth, Sr. Editor at DC Intervention and managing director at 20K Strategies, a political operations and public policy strategy firm. He is a thought leader for addiction, mental health, and workforce development.

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© 2020 by DC Intervention, a 20K Strategies affiliate.