Children's mental health visits to emergency departments increased during COVID-19 pandemic

In the Chicago area, pediatric mental health Emergency Department (ED) visits increased 27 percent at the onset of the COVID-19 pandemic, followed by a 4 percent increase monthly through February 2021, according to a study from Ann & Robert H. Lurie Children's Hospital of Chicago published in the journal Academic Pediatrics. The authors found increased ED visits for suicide, self-injury and disruptive behaviors, as well as higher admission rates for these children.

"During the pandemic, we found fewer ED visits for depression and anxiety and more visits for suicide or self-injury," said lead author Lavanya Shankar, MD, MS, a hospitalist at Lurie Children's and Health System Clinician of Pediatrics at Northwestern University Feinberg School of Medicine. "Our findings suggest that emergency care is increasingly reserved for more severe cases of mood disorders involving risk of self-harm. We also found increased pediatric ED visits for disruptive, impulse control and conduct disorders, which may have worsened because of inability to access outpatient services or because of psychosocial stressors imposed by the pandemic."

The study analyzed mental health ED visits by children age 5-17 years in the Chicago area from March 2018 to March 2021 at a 10-hospital academic medical system (one academic medical hospital and nine community hospitals) and Lurie Children's.

"Our study is unique in its examination of trends in pediatric mental health ED visits at community hospitals," said senior author Jennifer Hoffmann, MD, Emergency Medicine physician at Lurie Children's and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "We observed a relative increase in the proportion of children presenting to community hospitals compared to a children's hospital and academic medical ED. Given that most pediatric emergency care occurs at non-children's hospitals and the declaration of a national emergency in pediatric mental health by the American Academy of Pediatrics, all EDs should be equipped with adequate resources, policies, and staff training to manage pediatric mental health needs."