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Children in the emergency department are waiting longer to receive mental health care



CAccording to a new study, children sent to the emergency room for mental health care are more likely to be trapped there for long-term stay than they were ten years ago. Hispanic children are almost three times more likely to experience these delays in care than white children.

“Every minute, every hour, every day there is a mental health child [needs] The author of the study, Katherine Nash, published an article in the journal Pediatrics on Monday.

Nash of Nash University (Yash) and her team analyzed national survey data from 2005 to 2015, focusing on the length of stay in the emergency room of patients. They found that the rate of visits that lasted more than six hours due to children’s mental health problems increased from about 1

6% to nearly a quarter. The proportion of staying more than 12 hours increased from 5% to nearly 13%.

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Although the researchers are not sure what caused the delay, they believe it is a sign of worsening access to adequate pediatric mental health care.

Emergency departments are not designed for emergencies, and in most hospitals, they are not designed for children. Nash said they could be noisy, chaotic and painful experiences. Nonetheless, they are often an entry point for more professional care of children with mental health problems. Over the years, the number of teenagers experiencing mental health crises has increased, especially during the pandemic.

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With this surge, emergency rooms have become more bottlenecks, as children are forced to wait for the understaffed pediatric department to send a consultation doctor, or adults look for external facilities that can cope with their children’s unique comorbidities or risk factors. This study showed that only 16% of children who visited the emergency room had seen a mental health service provider.

When children are determined to be at high risk of harm to themselves or others, they will not be able to return home safely. These children may need to wait hours or even days in the emergency room until they can see a specialist or be transferred to an appropriate psychiatric hospital.

Lois Lee, a doctor at Boston Children’s Hospital, said: “We will never let children with diabetes wait a week to see an endocrinologist and start insulin treatment.” “But we let these children wait for a week. Get the care they need.”

Children who exhibit violent or dangerous behavior need experienced providers who can ensure their safety and provide medication when appropriate. Li said she saw children waiting for mental health services in the emergency room for several days at a time.

In the general emergency department, children waiting for mental health treatment will also delay the care of other emergency patients who need to be bedridden.

Polina Krass, a doctor at the Children’s Hospital of Philadelphia, said: “Utilization of emergency services is a valuable resource.”

For non-white Hispanic children, the barriers to passage appear to be higher, three times that of long-term stays. This difference does not exist in other ethnic groups, which has led experts to question whether language barriers can cause delays in care.

“The implication of this work is that in some cases, we can provide a better quality transition for final care,” Krass said.

Krass said that at least part of the solution to these delayed care may be outside the emergency room. For children with mental illness, more options are needed, so that they cannot wait weeks to see the therapist, but they are not so urgent that they need to stay overnight in the hospital. The latest pandemic stimulus plan passed by Congress does allocate funds to states to develop their own crisis response systems as a potential option for anyone to call 911. This is another number connected to the crisis center in addition to the new three-digit number 988 in the country. A mental health emergency signed into law last year.

Krass said that more descriptive research is needed to study the reasons why children with mental health crisis extend their stay in the emergency room in order to find more solutions.

“Because it is a management database, you don’t actually have a deep understanding of the details of the real experiences of these children, adolescents and families.” Lee said.

Nash hopes to continue to study the length of stay in pediatric patients and carefully study interventions that have not yet been tested in the emergency department.

Nash said: “A mentor once told me to study what makes you angry.” “And this is very important.”




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