Characteristics associated with presence of pediatric mental health care policies in emergency departments.
Open accessAbstract
OBJECTIVES: The majority of US children do not have access to an emergency department (ED) with a pediatric mental health care policy in place. Our objective was to understand factors associated with whether US EDs have a pediatric mental health care policy. METHODS: We analyzed data from the National Pediatric Readiness Project, a nationally representative cross-sectional survey of US EDs. Nurse managers reported whether their hospitals had a policy to care for children with social/mental health concerns (n = 3612). We calculated prevalence estimates, prevalence ratios (PRs), and confidence intervals (CIs) for regional and ED characteristics (eg, rurality and types of personnel) by whether EDs had a pediatric mental health care policy. RESULTS: Overall, 46.2% (n = 1668/3612) of EDs had a pediatric mental health care policy. Emergency departments located in remote areas were 60% less likely to have such a policy compared with EDs in urban areas (PR, 0.4; CI, 0.3-0.5). Emergency department characteristics associated with having a pediatric mental health care policy included having a policy to transfer children with social/mental health concerns (PR, 5.4; CI, 4.7-6.2), having a policy to address maltreatment (PR, 3.4; CI, 2.6-4.4), and having nurse and physician pediatric emergency care coordinators (PR, 1.6; CI, 1.5-1.8). CONCLUSIONS: Lower prevalence of pediatric mental health policies in rural EDs is concerning considering EDs are often the first point of contact for pediatric patients. This work highlights the importance of pediatric emergency care coordinators in fostering ED capacity to meet children's mental health needs.
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The majority of EDs lack adequate capacity to treat pediatric mental health concerns.
“The majority of EDs lack adequate capacity to treat pediatric mental health concerns (6)”
From Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020 (2020) · cites this paper as [6]
The Results report that only 46.2% of surveyed US EDs had a policy for children with social and mental health concerns. The Discussion says this *could indicate* a lack of capacity for triage and crisis intervention; it does not establish that a majority lack adequate capacity to treat these concerns. (LLM, conf=0.85)
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“The majority of EDs lack adequate capacity to treat pediatric mental health concerns (6), potentially increasing demand on systems already stressed by the COVID-19 pandemic.”
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- Authors
- Cree, R. A., So, M., Franks, J., Richards, R., Leeb, R., Hashikawa, A., Krug, S., Ludwig, L., & Olson, L. M.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Oak Ridge Institute for Science and Education (US)
- University of Utah (US)
- Michigan Medicine (US)
- Northwestern University (US)
- Health Resources and Services Administration (US)
- Corresponding author
- Cree, Robyn A.
- Leeb, Rebecca
- Venue
- Pediatric Emergency Care
- Published
- 2019-11-15
- Volume
- 37
- Issue
- 12
- Pages
- e1116-e1121
- ISSN
- 0749-5161 (ISSN-L)
- 1535-1815
- PMC
- PMC7217715
- OpenAlex
- W2989354162
- Cited by
- 26
- References
- 34
- Citations by year
- 2025: 5 · 2024: 8 · 2023: 6 · 2022: 4 · 2021: 1 · 2020: 1 · 2018: 1
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pediatric Emergency Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- emergency department, urban-rural differences, child abuse, access to mental health care
- MeSH terms
- Child, Cross-Sectional Studies, Emergency Medical Services, Emergency Service, Hospital, Health Policy, Humans, Mental Health
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