The average number of emergency department visits by children and adolescents seeking treatment for mental health problems exceeded 1 million per year from 2018-21, according to a new study from the Centers for Disease Control and Prevention.
The research builds on previous studies showing that mental health disorders among children and adolescents, including suicide attempts and suicides, have increased over the past decade.
In 2021, three children’s health organisations jointly declared a national emergency in children’s mental health, which they said had been exacerbated by the COVID-19 pandemic.
The CDC study, based on estimates from a survey of emergency department visits, found that there were an average of 1,026,000 annual visits by children and adolescents diagnosed with mental health disorders over the four-year period, or 14 visits per 1,000 children and adults.
Because of the declining number of mental health facilities and the inaccessibility of outpatient services, many children and adolescents have become more reliant on emergency departments for immediate mental health care, the authors note.
About one in five patients were either admitted to hospital or transferred to a psychiatric facility, according to the study. A quarter of patients received or were prescribed at least one psychiatric medication.
Mood disorders (5 visits per 1,000 children), anxiety disorders (4.4 visits) and behavioural and emotional disorders (3.7 visits) were the most common conditions treated. This is consistent with other research showing that anxiety, depression, attention-deficit/hyperactivity disorder and conduct disorder are the most common mental health conditions seen in children and adolescents.
Emergency visits were much higher among adolescents aged 12-17 (30.7 per 1,000) than among children under 12 (5.3), which differs from non-mental health visits, where children account for about 1½ times as many visits as adolescents.
The researchers found that adolescents had higher rates of the most common mental health disorders – such as depression – than children.
Girls (16.1 visits per 1,000) were more likely than boys (12.1) to be treated in emergency departments for mental health disorders, the study found. Meanwhile, black children and adolescents (20.8 visits per 1,000) outnumbered other races and ethnicities per capita, followed by white (14.4) and Hispanic (13.2) patients.
The study authors wrote that they compared estimates from 2020 with other years because of concerns that the pandemic might have affected the data. But they said they found no statistically significant differences.
