More girls visited emergency departments for mental health needs in pandemic

Researchers continue to find troubling indicators of mental health challenges among America’s young people stemming from the COVID-19 pandemic.

More girls continue to show up in emergency departments with mental health needs, even in the latter stages of the pandemic, according to findings published April 2 in Academic Emergency Medicine.

In addition, researchers found young people were spending longer amounts of time in hospital emergency departments for mental health reasons. The study found a sharp increase in the number of kids spending more than 12 hours in emergency departments.

Jennifer Hoffmann, MD, the study’s lead author and an emergency medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago, said that the pandemic had an impact on the mental health of some girls.

“We observed a unique vulnerability for girls during the pandemic, which indicates that girls’ mental health requires more attention,” Hoffman said in a statement released by Lurie Children’s.

Mental health visits to emergency departments were lower than expected for males during the pandemic, but higher than expected for females during the mid-pandemic and late pandemic, the study found.

Researchers examined 175,979 pediatric mental health visits at nine U.S. hospitals participating in the Pediatric Emergency Care Applied Research Network Registry from 2017 to 2022. They found more kids and teens were spending lengthy periods in the emergency department.

Before the pandemic, 7.3% of pediatric mental health visits to the emergency department lasted more than 12 hours. By the latter period of the pandemic, the percentage rose to 19.2%, meaning almost 1 in 5 kids with mental health emergencies spent more than 12 hours in the emergency department.

“Pediatric emergency departments saw more severe mental health presentations during the pandemic, even while the actual number of visits decreased in 2022,” Hoffman said in a statement. “The dramatic increase in prolonged ED stays attests to the strain on the system and difficulties finding appropriate psychiatric care for children, whether in the hospital or in the community.”

The researchers noted that the longer boarding times in emergency departments could be tied to the lack of mental health services for kids in the community.

The number of children returning to emergency departments for mental health reasons after a previous visit remained high, researchers said. About one in 10 children returned to emergency departments for mental health reasons within 30 days, the study found.

• Read more: Rady Children’s finds success in reducing mental health visits to emergency department

The study found no differences in expected rates of mental health visits to emergency departments by race and ethnicity.

However, researchers found higher rates of emergency department visits for addictive disorders, and schizophrenia spectrum disorders.

The researchers suggested some remedies to reduce the number of children with mental health emergencies, including integrating mental health care into primary care practices and schools and expanding access to telehealth services. They also pointed to the need to expand the mental health clinician workforce.

Leaders of children’s hospitals have warned of a growing mental health crisis among kids and teens.

Lawrence Moss, president and CEO of Nemours Children’s Health, told Chief Healthcare Executive® in a November interview that the system has seen an increase in adolescents needing treatment at the system’s children's hospitals for mental health issues. Moss says the rise in mental health needs among children is a serious problem.

“It is at risk of overwhelming the system,” Moss said. “And yes, we need to as a society, take it seriously and come up with answers.”

Charles Schleien, senior vice president of pediatric services at Northwell Health, said the system saw a substantial increase in children with mental health emergencies. While he said the number has fallen from the pandemic’s peak, Schleien said, “Where we're leveling out is at a much higher level than we were pre-pandemic.”

“It's still at a much higher level than we had seen three, four years ago,” he says.

Northwell Health is investing $500 million in a new children’s mental health pavilion, which will be connected to Cohen Children’s Medical Center and Zucker Hillside Hospital, an adult mental health facility, in Queens, N.Y.

The Children’s Hospital Association said in December that 94% of children’s hospitals reported that they’ve seen an increase in the number of pediatric patients requiring mental healthcare. More than half of children’s hospitals (58%) surveyed said they are concerned about a lack of mental health resources to care for those patients.

U.S. Surgeon General Vivek Murthy issued an advisory about the mental health crisis in youth in December 2021. Dozens of healthcare organizations have described the pediatric mental health crisis as a national emergency.