Emergency room physicians and specialists in pediatrics are urgently appealing for assistance in managing an overwhelming influx of children and teenagers seeking help for mental health issues at emergency departments.
A joint report released on Wednesday by the American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), and Emergency Nurses Association (ENA) has highlighted a dramatic surge in mental health emergencies among young individuals, leading to a strain on emergency departments.
The affected minors often present with critical conditions linked to anxiety, depression, and instances of suicidal ideation or attempts, according to the collaborating organizations.
Dr. Mohsen Saidinejad, the lead author of the report and head of pediatric emergency medicine at Ronald Reagan UCLA Medical Center, emphasized that emergency rooms have essentially become inadvertent focal points for these challenges, placing an overwhelming burden on the departments.
Dr. Saidinejad, who is also actively involved with the AAP and ACEP committees focusing on pediatric emergency medicine, underscored that emergency room personnel lack the specialized expertise required for comprehensive mental health care, thus rendering definitive treatment an unfeasible endeavor.
The report underscores that nearly half a million children grappling with mental or behavioral health issues turn to emergency departments each year. This number was already on the rise before the pandemic, but the crisis has been further exacerbated by the ongoing pandemic, as indicated by the medical bodies.
The intricate nature of mental health crises in pediatric patients poses a distinct challenge for emergency rooms. These cases tend to necessitate significantly extended hospital stays, averaging about 17 hours compared to the typical five-hour stay for non-mental health-related emergency room visits.
Furthermore, these pediatric mental health emergencies exhaust resources that would have otherwise been allocated for regular medical operations, inadvertently causing an extended length of stay for all patients in emergency departments.
Another pertinent issue pertains to the fact that children arriving at emergency departments in crisis are less likely to receive the necessary follow-up care compared to those who access specialized psychiatric crisis centers or community mental health facilities, Dr. Saidinejad observed.
In response to this critical situation, the medical organizations propose a series of strategic interventions. They recommend the establishment of community-based teams, capable of promptly addressing crisis situations in educational institutions, medical offices, and even residences. Additionally, embedding pediatric mental health specialists within emergency departments is suggested. The organizations also advocate for equipping emergency department staff with relevant information about high-risk children, including victims of abuse and individuals struggling with post-traumatic stress disorder.
The authors of the report assert that the nation’s mental health infrastructure needs a significant expansion. Presently, there exists only one mental health professional for every 124,000 children, with as many as 55% of all counties lacking even a single psychiatric specialist, Dr. Saidinejad disclosed.
The authors also highlight the potential of telehealth services for addressing children’s mental health concerns, potentially intervening before situations escalate to the point of necessitating emergency room intervention.
In summary, Dr. Saidinejad encapsulated the scenario by characterizing emergency rooms as a vital safety net that must accommodate all cases, thereby contributing to the current scenario where a broad spectrum of cases is directed to emergency departments.