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Trends in Psychiatric Emergency Department Visits Among Youth and Young Adults in the US
Open accessAbstract
BACKGROUND: Visits to the emergency department (ED) for psychiatric purposes are an indicator of chronic and acute unmet mental health needs. In the current study, we examined if psychiatric ED visits among individuals 6 to 24 years of age are increasing nationwide. METHODS: ED data came from the 2011–2015 National Hospital Ambulatory Medical Care Survey, a national survey of ED visits across the United States. Psychiatric ED visits were identified by using the International Classification of Diseases, Ninth Revision and reason-for-visit codes. Survey-weighted logistic regression analyses were employed to examine trends in as well as correlates of psychiatric ED visits. Data from the US Census Bureau were used to examine population rates. RESULTS: Between 2011 and 2015, there was a 28% overall increase (from 31.3 to 40.2) in psychiatric ED visits per 1000 youth in the United States. The largest increases in psychiatric ED visits per 1000 US youth were observed among adolescents (54%) and African American (53%) and Hispanic patients (91%). A large increase in suicide-related visits (by 2.5-fold) was observed among adolescents (4.6–11.7 visits per 1000 US youth). Although psychiatric ED visits were long (51% were ≥3 hours in length), few (16%) patients were seen by a mental health professional during their visit. CONCLUSIONS: Visits to the ED for psychiatric purposes among youth are rising across the United States. Psychiatric expertise and effective mental health treatment options, particular those used to address the rising suicide epidemic among adolescents, are needed in the ED.
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“In recent years, the number of emergency department (ED) visits for psychiatric illness has been rising worldwide [1, 3, 4].”
From Bridging the gap between the emergency department and outpatient care: feasibility of a short-term psychiatric crisis intervention for children and adolescents (2023) · cites this paper as [4]
Experimental — accuracy not yet measuredIn the citing paper
“Youth in a suicidal crisis are at increased risk since nearly 25% of people police killed in the last seven years had a documented mental disorder (83).”
From Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems (2022) · cites this paper as [83]
In the citing paper
“A number of studies indicated greater incidence of suicide attempts among certain adult subgroups and youth (Table 1).[7][8][9][10][11][12][13]”
From Trends in the Incidence and Lethality of Suicidal Acts in the United States, 2006 to 2015 (2020) · cites this paper as [8]
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Metadata
- Authors
- Kalb, L. G., Stapp, E. K., Ballard, E. D., Holingue, C., Keefer, A., & Riley, A.
- Affiliations
- Kennedy Krieger Institute (US)
- Genetic Epidemiology Research Branch and
- National Institute of Mental Health (US)
- Departments of Mental Health and
- Johns Hopkins University (US)
- Corresponding author
- Kalb, Luther G.
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2019-04-01
- Volume
- 143
- Issue
- 4
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC6564072
- OpenAlex
- W2922218868
- Cited by
- 285
- References
- 37
- Citations by year
- 2026: 25 · 2025: 30 · 2024: 49 · 2023: 61 · 2022: 47 · 2021: 34 · 2020: 26 · 2019: 13
- FWCI
- 35.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- PEDIATRICS (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- psychiatric emergency department visits, youth mental health, adolescents, young adults, unmet mental health needs, racial and ethnic disparities, emergency department utilization trends, access to mental health care
- MeSH terms
- Adolescent, Mental Disorders, Black or African American, Emergency Service, Hospital, Female, Hispanic or Latino, Humans, Male, Retrospective Studies, Severity of Illness Index, Suicide, Attempted, United States, Incidence, Multivariate Analysis, Logistic Models, Databases, Factual, Age Distribution, Sex Distribution, Risk Assessment, Young Adult
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