Study: More Children Than Ever Before Need Urgent Mental Health Care, But Many Emergency Departments are Unprepared to Treat Them

Experts urge mental health screening, physician training and telehealth options

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(COLUMBUS, Ohio) – When a child is in crisis, the most likely place they go for urgent mental health care is the nearest emergency department, an increasingly critical resource as suicidal ideation and attempts continue to rise among children. Now, a new study by researchers at Nationwide Children’s Hospital finds there was a 60 percent increase in children visiting U.S. emergency departments for mental health concerns. The study also found that self-harm cases more than tripled and substance abuse disorders increased nearly 160 percent over the 10-year study period.

     “These children didn’t just come to children’s hospital EDs. In fact, most of them came to general emergency departments that see less than 15 to 20 children each day,” said Rachel Stanley, MD, Division Chief for Emergency Medicine at Nationwide Children’s Hospital. “In rural areas, only 30 percent of emergency departments are prepared to manage children with urgent mental health disorders.” 

     Experts say it is imperative that every hospital is prepared for pediatric mental health emergencies because lives can be saved if the correct steps are taken when children in crisis walk through their doors. Those experts are urging every emergency department and primary care physician to implement regular mental health screenings for children and training for physicians who directly care for these patients. 

     “They don’t have to be psychiatrists. They can have a short training course to learn how to triage and manage these children,” Stanley said. “But they can’t do everything, so it’s also important that they receive help from their local or their regional specialized centers who have additional expertise to treat these patients.” 

     Nationwide Children’s is leading efforts to ensure every hospital has the resources to effectively treat pediatric behavioral health issues with plans to partner with rural providers and hospitals for telepsychiatry sessions. These will allow behavioral health experts to assess patients remotely and participate in shared decision-making with emergency physicians in different communities.


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Rachel Stanley, MD, collaborates with a nurse in the emergency department at Nationwide Children’s Hospital. Stanley led a new study that found the rate of children visiting U.S. emergency departments for self-harm more than tripled over a 10-year period, highlighting the need for all emergency departments to have protocols in place to treat children in crisis.

After suffering from severe depression and finally confiding in her mother, Meaghan Saunders received the care she needed. A new study finds this specialized care is increasingly critical for children, with major increases in the number of children visiting emergency departments for self-harm, substance abuse and other mental health concerns.

Nationwide Children’s Hospital is working to ensure all emergency departments are prepared to help children with mental and behavioral health concerns, something less than a third of rural hospitals have protocols for.

Meaghan Saunders says her doctors and counselors at Nationwide Children’s Hospital helped her develop a safety plan to manage her depression, including coping mechanisms like writing in a journal.

Rachel Stanley, MD, (right) and Charmaine Lo, PhD, review data from a new study by Nationwide Children’s Hospital showing a 60 percent increase in children visiting U.S. emergency departments with mental health concerns over a 10-year period.

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