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The rate of emergency department visits among children and youth for mental health concerns has risen dramatically across dozens of U.S. hospitals since 2012, with the rate of mental health diagnoses notably high among black patients, according to newly released study findings.
"The rates of pediatric emergency department visits for mental health-related concerns are increasing … across all racial and ethnic groups," says Dr. Monika Goyal, the study's senior author. "However, when compared to non-Hispanic white children, non-Hispanic black children are being disproportionately affected."
For the study, researchers analyzed data from the Pediatric Health Information System on emergency department visits for patients 21 years old and younger from 2012 through 2016 at more than 45 children's hospitals. Overall, the rate of mental health-related visits increased from 50.4 visits per 100,000 in 2012 to 78.5 per 100,000 in 2016, with visits increasing at a higher rate for non-Hispanic black patients than non-Hispanic whites.
Of the more than 240,000 patients who received mental health-related diagnoses, non-Hispanic black patients were diagnosed at a rate of 78.4 per 100,000, far outpacing the rate of diagnosis for non-Hispanic whites (51.5). Hispanic patients, at a rate of 38.1 per 100,000, had the lowest rate of mental health diagnoses among the racial and ethnic groups examined.
Goyal, assistant division chief and director of research in the Emergency Medicine Division at Children's National Health System, says the study results show the need to increase local mental health resources, such as counseling, community support services, and crisis prevention and intervention strategies, especially to aid minority communities.
"One, we need to increase capacity in our emergency departments to care for children with mental health-related concerns, and two, we also need to consider increasing community resources so that we can prevent children from presenting to emergency departments in crisis," she says.
The analysis encompassed a broad range of mental health-related diagnoses, including cases of acute anxiety, bipolar disorder, depression, substance abuse and dependence, eating disorders, behavioral disorders, and schizophrenia. More than half of the patients diagnosed with a mental health-related issue were covered by public health insurance, and the average age of patients was 13.3 years old.
The study's findings will be presented Friday at the American Academy of Pediatrics National Conference and Exhibition in Florida. They come as recent research also has shown that suicide rates among young black children have been roughly twice as high as the rates of their white counterparts.
Goyal says her study's results were limited by how race and ethnicity data are collected in the U.S., and that there may have been some coding errors in the database used.
And while she cautions that the results are gleaned from a subset of hospitals and are not nationally representative, she says they still underscore a need.
"We know that there is a shortage of outpatient mental health services," Goyal says. "We also know that overall, minority children have less access to medical care. And I think what this research is suggesting is that this accessibility issue also expands to mental health services."