Emergency Department Utilization for Mental Health in American Indian Children
Open accessAbstract
Objectives To examine emergency department (ED) visits for mental health concerns by American Indian children in a multicenter cohort. To analyze demographic and clinical factors, the types of mental health concerns, and repeat mental health visits.Study design Cross-sectional study of children 5-18 years old who visited 1 of 6 EDs in the Upper Midwest from June 2011 to May 2012 and self-identified as white or American Indian. Mental health visits were identified by primary diagnosis and reasons for visit and were categorized into diagnostic groups. We explored racial differences in ED visits for mental health, diagnostic groups, and repeat mental health visits. Analysis involved χ(2) tests, Cochran-Mantel-Haenszel tests, and regression models including age, triage, timing, and insurance, and their interactions with race.Results We identified 26 004 visits of which 1545 (5.4%) were for a mental health concern. The proportion of visits for mental health differed by race and age. American Indian children had lower odds of a mental health visit for 5-10 year olds (OR, 0.40; 95% CI, 0.26-0.60), but higher odds for 11-17 year olds (OR, 1.62; 95% CI, 1.34-1.95). In the older age group, American Indian children were seen primarily for depression and trauma- and stressor-related disorders, whereas white children were seen primarily for depression and disruptive, impulse control, and conduct disorders. Repeat visits were not different by race.Conclusions Differences were noted in mental health visits between American Indian and white children and were influenced by age. These findings warrant further investigation into care-seeking patterns and treatment for mental health in American Indian children.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Youth who visit the pediatric emergency department represent a key group of children at risk for adverse health outcomes.
“Youth who visit the Pediatric Emergency Department (PED) represent a key group of children at risk for adverse health outcomes.”
From Association of Physical Activity, Sports, and Screen Time With Adolescent Behaviors in Youth Who Visit the Pediatric Emergency Department (2022) · cites this paper as [14]
Many youth who visit the pediatric emergency department have high rates of substance use, risky sexual behavior, conduct disorder, and depression.
“Furthermore, many have high rates of substance use, risky sexual behavior, conduct disorder and depression.11–14”
From Association of Physical Activity, Sports, and Screen Time With Adolescent Behaviors in Youth Who Visit the Pediatric Emergency Department (2022) · cites this paper as [14]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Mental Health Surveillance Among Children — United States, 2013–2019
Bitsko, R. H., Claussen, A. H., Lichstein, J., Black, L. I., Jones, S. E., Danielson, M. L., Hoenig, J. M., Davis Jack, S. P., Brody, D. J., Gyawali, S., et al. (2022) · MMWR Supplements · doi:10.15585/mmwr.su7102a1 · Cited by 1,723 · see citing works
DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FIFTH EDITION
Abbas, A., & Aminoroaia, M. (2013) · Cited by 1,478 · see citing works
Brave Heart, M. Y. H., Chase, J., Elkins, J., & Altschul, D. B. (2011) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2011.628913 · Cited by 825 · see citing works
(2013) · PubMed · Cited by 770 · see citing works
American Indian and Alaska Native mental health: diverse perspectives on enduring disparities
Gone, J. P., & Trimble, J. E. (2012) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032511-143127 · Cited by 440 · see citing works
Sarche, M., & Spicer, P. (2008) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1425.017 · Cited by 339 · see citing works
Trends in U.S. Emergency Department Visits for Mental Health Conditions, 1992 to 2001
Larkin, G. L., Claassen, C. A., Emond, J. A., Pelletier, A. J., & Camargo, C. A. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.6.671 · Cited by 326 · see citing works
Costello, E. J., Farmer, E. M. Z., Angold, A. C., Burns, B. J., & Erkanli, A. (1997) · American Journal of Public Health · doi:10.2105/ajph.87.5.827 · Cited by 270 · see citing works
Pediatric and Adolescent Mental Health Emergencies in the Emergency Medical Services System
Dolan, M. A., Fein, J. A., & the Committee on Pediatric Emergency Medicine (2011) · Pediatrics · doi:10.1542/peds.2011-0522 · Cited by 235 · see citing works
Social Epidemiology of Trauma Among 2 American Indian Reservation Populations
Manson, S. M., Beals, J., Klein, S. A., Croy, C. D., & the AI-SUPERPFP Team (2005) · American Journal of Public Health · doi:10.2105/ajph.2004.054171 · Cited by 229 · see citing works
Psychiatric Disorder Among American Indian Adolescents: Prevalence in Northern Plains Youth
Beals, J., Piasecki, J., NELSON, S., Jones, M. C., Keane, E., Dauphinais, P., SHIRT, R. R., Sack, W. H., & Manson, S. M. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199709000-00018 · Cited by 167 · see citing works
Summary Statistics for Pediatric Psychiatric Visits to US Emergency Departments, 1993–1999
Sills, M. R., & Bland, S. D. (2002) · PEDIATRICS · doi:10.1542/peds.110.4.e40 · Cited by 162 · see citing works
Trends in Pediatric Emergency Department Utilization for Mental Health-Related Visits
Mapelli, E., Black, T., & Doan, Q. (2015) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2015.07.004 · Cited by 156 · see citing works
Mental Health Utilization in a Pediatric Emergency Department
Sheridan, D. C., Spiro, D. M., Fu, R., Johnson, K., Sheridan, J. S., Oue, A. A., Wang, W., Nes, R. V., & Hansen, M. L. (2015) · Pediatric Emergency Care · doi:10.1097/pec.0000000000000343 · Cited by 116 · see citing works
Grupp‐Phelan, J., Harman, J. S., & Kelleher, K. J. (2007) · Public Health Reports · doi:10.1177/003335490712200108 · Cited by 114 · see citing works
The Prevalence of Serious Emotional Disturbance: A Re-Analysis of Community Studies
Costello, E. J., Messer, S. C., Bird, H., Cohen, P. R., & Reinherz, H. Z. (1998) · Journal of Child and Family Studies · doi:10.1023/a:1022901909205 · Cited by 106 · see citing works
Pediatric Mental Health Emergencies in the Emergency Medical Services System
Dolan, M. A., & Mace, S. E. (2006) · PEDIATRICS · doi:10.1542/peds.2006-1925 · Cited by 98 · see citing works
Whitbeck, L. B., Yu, M., Johnson, K. D., Hoyt, D. R., & Walls, M. L. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e3181799609 · Cited by 91 · see citing works
Emergency Department Visits for Mental Health Conditions Among US Children, 2001-2011
Simon, A. E., & Schoendorf, K. C. (2014) · Clinical Pediatrics · doi:10.1177/0009922814541806 · Cited by 88 · see citing works
Psychiatric emergencies in children
Christodulu, K. V., Lichenstein, R., Weist, M. D., Shafer, M. E., & SIMONE, M. (2002) · Pediatric Emergency Care · doi:10.1097/00006565-200208000-00009 · Cited by 84 · see citing works
The Prevalence of Suicidal Behaviors Among Northern Plains American Indians
LeMaster, P. L., Beals, J., Novins, D. K., & Manson, S. M. (2004) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.34.3.242.42780 · Cited by 70 · see citing works
A Mental Health Needs Assessment of Urban American Indian Youth and Families
West, A. E., Williams, E., Suzukovich, E. S., Strangeman, K., & Novins, D. K. (2011) · American Journal of Community Psychology · doi:10.1007/s10464-011-9474-6 · Cited by 61 · see citing works
Dickerson, D. L., & Johnson, C. L. (2010) · Community Mental Health Journal · doi:10.1007/s10597-010-9368-3 · Cited by 50 · see citing works
Child and Youth Emergency Mental Health Care: A National Problem
Cooper, J. L., & Masi, R. (2007) · Issue Lab (Candid) · doi:10.7916/d8zk5rch · Cited by 20 · see citing works
Child Mental Health Services in the Emergency Department
Lynch, S. E., Bautista, M., Freer, C., Kalynych, C. J., & Hendry, P. L. (2015) · Pediatric Emergency Care · doi:10.1097/pec.0000000000000336 · Cited by 18 · see citing works
An Examination of Emergency Department Pediatric Psychiatric Services
Brown, J. F., & Schubert, C. M. (2009) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-009-9189-8 · Cited by 11 · see citing works
Podlogar, M. C., & Novins, D. K. (2015) · Psychological Services · doi:10.1037/a0038560 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [21]Gilboy Nicki Tanabe Paula Travers Debbie Rosenau Alexander M Emergency severity index (ESI): A triage tool for emergency department care, Version 4 Implementation Handbook 2012 Edition Rockville (MD) Agency for Healthcare Research and Quality 2011
Cited by
Sorted by citations
McMichael, B. S., Nickel, A. J., Duffy, E. A., Skjefte, L., Lee, L., Park, P., Nelson, S. C., Puumala, S. E., & Kharbanda, A. B. (2018) · Journal of Patient Experience · doi:10.1177/2374373518798111 · Cited by 14 · see citing works
Self-citationShenoi, R. P., Linakis, J. G., Bromberg, J. R., Casper, T. C., Richards, R., Chun, T. H., Gonzalez, V. M., Mello, M. J., & Spirito, A. (2022) · Clinical Pediatrics · doi:10.1177/00099228221075094 · Cited by 12 · see citing works
Wilson, R. J., Jennings, A. E., Redaniel, M. T., Samarakoon, K. B., Dawson, S., Lyttle, M. D., Savović, J., & Schofield, B. (2024) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2024.04.018 · Cited by 5 · see citing works
Leveraging Local Indigenous Community Voices to Inform Pediatric Healthcare: A Workshop Summary
Tsosie, C. R., Evans-Lomayesva, G., Baricuatro, M. A. K., Kline, C., Lowenthal, E. D., & Sanseau, E. (2026) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2026.115287
- Authors
- Pickner, W. J., Puumala, S. E., Chaudhary, K. R., Burgess, K. M., Payne, N. R., & Kharbanda, A. B.
- Affiliations
- Sanford Research (US)
- University of South Dakota (US)
- Colorado School of Public Health (US)
- Children's Minnesota (US)
- Corresponding author
- Kharbanda, Anupam B.
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 174
- Pages
- 226-231.e3
- ISSN
- 0022-3476 (ISSN-L)
- PMC
- PMC4925236
- OpenAlex
- W2342848578
- Cited by
- 4
- References
- 27
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 1 · 2018: 1
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Minority Health and Health Disparities (U54MD008164)
- Topics
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- emergency department visits, child mental health, Native American children, racial disparities, depression, trauma- and stressor-related disorders, conduct disorder, age differences
- MeSH terms
- Adolescent, Mental Disorders, Child, Child, Preschool, Cross-Sectional Studies, Emergency Service, Hospital, Female, Humans, Indians, North American, Male, Patient Acceptance of Health Care, Socioeconomic Factors, Triage, Midwestern United States, Cohort Studies, Outcome Assessment, Health Care, White People
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
