The State of Emergency Department Visits by Young People

The most recent Centers for Disease Control and Prevention (CDC) survey reports 6.2 million emergency department (ED) visits with a primary diagnosis related to mental, behavioral, and neurodevelopmental disorders. The same report also cites suicide as the second leading cause of death in young people ages 10 to 14 years. The latest Morbidity and Mortality Weekly Report summarizes mental and behavioral health conditions and drug overdose-related ED visits by adolescents who are 12 to 17 years old between January 2019 to February 2023. 

Key Findings 

1. ED visits for mental health conditions, suicide-related behaviors, and drug overdoses have declined since Spring 2019 to today; however, each still is a public health concern with estimated increases of 33 percent, 62 percent, and 50 percent, respectively. 

2. The top three mental health conditions concerns continue to be depression, anxiety, and trauma- and stressor-related disorders. 

3. Variability trends related to time points in school semesters remained, with the lowest number of visits often occurring during summer and winter semester breaks.  

4. There is an increase of Females visiting the ED for mental health conditions, suicide-related behaviors, and drug overdoses. 

5. There were notable sex differences in opioid-involved overdoses between female (+10 percent) and male (41 percent) patients. 

6. Eating disorders, opioid-involved overdoses, and obsessive-compulsive disorder-related visits are trending upward.  

As poor mental and behavioral health is still a significant public health problem, particularly among adolescent females, improved approaches to providing effective care to these vulnerable patients in the ED are needed. Let’s explore key approaches ED healthcare professionals can take to address the ongoing mental and behavioral health crisis. 

Key Approaches 

To address the ongoing mental and behavioral health crises in the ED, here are the key approaches: 

1. Identify patients and those at risk through validated assessments for further evaluation and treatment.  

2. Collaborate with a network of healthcare professionals to provide comprehensive care, which includes coordinating care and referrals for continued care.  

3. Minimize time when patients are secluded, physically restrained, and kept in overstimulating environments that may be perceived as frightening.  

4. Provide trauma-informed care, which includes establishing a safe and supportive environment such as using non-judgmental, patient-centered language and resources. 

5. Engage with professional development activities to stay up to date on the dynamic causes of ED visits and systematic strategies to incorporate best practices.