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Why do children with mental health crises have longer ER wait times?

Amy Norton Health Day Reporter

Tuesday, April 6, 2021 (HealthDay News)

Children in the United States usually wait hours in the emergency room for help mental health Crisis-A new study has discovered a problem that is getting worse over time.

Researchers found that between 2005 and 2015, long-term ER stays became more and more common for children and teens in need. mental health Help. By 2015, nearly a quarter of children were in the ER for at least 6 hours. This is an increase from 16% 10 years ago.

According to experts, this situation is likely to reflect a long-term, deteriorating problem. There are too few mental health providers for children in the United States.

Dr. Kenduckworth, Chief Medical Officer of the National Alliance, a non-profit organization, said: Mental illness In Arlington, Virginia.

Duckworth, who was not involved in the investigation, called the findings important and said they were demonstrating the “crisis” the country is facing in the mental health workforce.

In addition, the shortage of healthcare providers extends beyond rural and urban areas where all types of health care may be in short supply.

“This is a widespread problem,” said Dr. Jennifer Hoffman, one of the researchers in the study and an ER doctor at Lully Children’s Hospital in Chicago.

According to Hoffman, the survey period was 2015, COVID-19 (new coronavirus infection) The pandemic has only increased the demand for pediatric mental health services. Her hospital has doubled the rate of ER visits for mental health status since the pandemic began.

Children in mental health crisis can enter the ER for a variety of reasons, Hoffman said.Sometimes they suicide Or you intentionally hurt yourself.Sometimes they have Panic attack Or a serious behavioral problem. From time to time, they and their parents have no other place to seek mental health help.

According to both Hoffman and Duckworth, long-term ER visits (sometimes over 12 hours) are closely tied to the supply of the provider.

According to Hoffman, studies show that only about 10% of that time is spent on actual medical evaluation. Most of your ER stay is to find the right follow-up care for your child-book a bed if you need to be hospitalized, or an outpatient mental health appointment.

“It can take up to two weeks to make an appointment, which isn’t feasible for these kids,” Hoffman said.

If no quick appointment with a specialist is found, she said the primary care provider is filling the void.

Findings-Published in the journal on April 5th Pediatrics -Based on information from a US federal survey tracking ER visits nationwide. The researchers analyzed about 150 million visits by children aged 6 to 17 between 2005 and 2015. Over 7 million people were due to mental health reasons.

Throughout that period, ER visits were longer for children in need of mental health than those with a rigorous physical diagnosis. During that time, long-term stays for mental health became more and more common, but there were no such changes due to physical condition.

By 2015, nearly 13% of ERs have been dragged in for more than 12 hours for mental health. This is an increase from 5% in 2005.

Hispanic children were particularly vulnerable to staying in these marathons, and white children faced three times the risk.

According to Hoffman, the reason is not clear, but some well-known obstacles may be at work. Hispanic families may live in areas where mental health services are particularly lacking, but language barriers can make it difficult to find a provider.

Researchers have found that there is no link between the type of insurance the family had (private or Medicaid) and the length of stay in the ER.

According to researchers, mental health care for children is expensive, and “second-best” reimbursement for these services is part of the problem.

Medicaid, a government program for low-income Americans, targets mental health care. However, Hoffman pointed out that the details vary from state to state.

It is important that children receive basic care before they are at stake. Hoffman said expanding the coverage of “telemedicine” services could be as helpful as a larger investment in school-based mental health services.

But according to Duckworth, the central issue is the need to expand the professional workforce. This includes children’s psychiatrists who take 12 years to educate and train, as well as mental health care trained nurses, social workers and other health care providers.

Parents who are concerned about their child’s mental health can consult a pediatrician, Hoffman said.

She also encouraged children to “talk openly” and allow them to turn somewhere.

In general, Hoffman pointed out that children tend to work better with limited screen time and can get enough. sleep And physical activity.

For more information

National alliance Mental illness There are details Teen mental health..

Source: Dr. Jennifer Hoffman, MD, Pediatric Emergency Doctor, Anne & Robert H. Lully Children’s Hospital, Chicago, Associate Professor Pediatrics, Northwestern University School of Medicine, Chicago; Ken Duckworth, MD, Chief Medical Officer of the National Federation of Mental Illness Families in Arlington, Virginia. Pediatrics , April 5, 2021, online

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