Kids' ER visits for mental health crises rise when school term begins

While the start of the school year can give kids and teens the chance to reconnect with friends and enjoy school sports and activities, it can also trigger stressors that send many to the emergency room for mental health woes, a new report shows.
Among children aged 5 to 17, emergency department visits for depression, suicidal thoughts, stress and substance abuse increased significantly in the fall and remained high through the spring, the report from the U.S. Centers for Disease Control and Prevention found.

"The academic school year is a time when parents and caregivers, educators, health care providers and others who regularly interact with children and adolescents can be aware of mental health concerns in children and adolescents, and be ready to respond appropriately," a CDC spokesperson said.

"Placing priority on programs and activities that protect emotional well-being like physical activity, nutrition, sleep, social, community or faith-based support, and inclusive school and community environments, may improve mental health among children and adolescents, and reduce mental health crises that require a trip to the emergency department," the spokesperson added.

The factors that contribute to the increase in mental issues—like social media, peer pressure or home life—weren't addressed in the research, the spokesperson noted.

For the study, published Sept. 22 in the CDC's Morbidity and Mortality Weekly Report, researchers used data from the National Syndromic Surveillance Program for 25 distinct conditions from January 2018 to June 2023.

"Each year, during 2018 to 2023, the number and proportion of weekly emergency department visits [for] depressive disorders, suicidal ideation or self-harm, trauma- and stressor-related disorders, lifestyle or life management factors, mood disorders, poisoning by drugs, and symptoms of mental and substance use conditions were up to two times higher during the school semesters compared to summers among children and teens aged 10 to 17 years," the spokesperson noted.

For children aged 5 to 9, the number and proportion of emergency department visits increased for depressive disorders, suicidal ideation or self-harm, trauma- and stressor-related disorders, mood disorders, and symptoms of mental and substance use conditions, the researchers found.

"Parents and caregivers, educators, health care providers, and others who regularly interact with children and adolescents can learn about signs and symptoms of mental distress and monitor children and adolescents for possible increases in mental distress in the weeks leading up to and during the academic year," the CDC spokesperson said.

Increases in emergency department visits among children and teens have been on the rise for a number of years, said Dr. Victor Fornari, vice chair of child and adolescent psychiatry at Zucker Hillside Hospital & Cohen's Children's Medical Center, in Glen Oaks, N.Y.

"Child and adolescent emergency room mental health visits have been on the rise over the past several decades, with a dramatic increase over the past decade," Fornari said. Seasonal variations in these psychiatric emergencies reflect the various activities related to school, peers and family life, he added.

As these problems have increased, schools have been forced to play an ever-expanding role in their students' mental well-being, Fornari noted.

"Schools have now become immersed with the concern about caring for youth with serious psychiatric issues, particularly suicidal thoughts and behaviors," he explained.

It's not surprising that the school year sees an uptick in these problems as stresses mount and kids have to deal with school and social pressures.
"The seasonal variations reported highlight the need to educate schools and families about this and to work towards developing collaborative community strategies to strengthen youth and to support families during these high-stress periods," Fornari said. "Further research and public health efforts to mitigate these serious concerns are needed."

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