Children Often Do Not Get Follow-Up They Need After Mental Health ER Visits, Study Warns

A failure to receive follow-up mental health care often leads to worsening mental health problems, including suicidal thoughts and the risk of self-harm or harming others, the study found.

A new study warns that nearly half of children treated in the emergency room for mental health issues do not receive crucial follow-up care.

The findings were published this week in the journal Pediatrics, indicating roughly one-quarter of children and teens seen for mental health crisis return to the ER within six months, because they never received the mental health care that they needed following the initial visit.

Researchers from the Children’s Hospital of Chicago used data from the IBM Watson MarketScan Medicaid database to conduct a retrospective study of 28,000 children, ages six to 17 years old, who had mental health ER discharges from 2018 to 2019.

About one-third of the children had a follow-up mental health outpatient visit within a week of going to the emergency room, and only 55% had a follow-up mental health visit within 30 days. About 26.5% of the children found themselves back in the ER for mental health issues again within six months, the researchers found.

Follow-up with a mental health care provider can help reduce a child’s risk of suicide, increase the chance they will take prescribed medication, and decrease the likelihood of repeat visits to the ER. But lack of professional help can be a problem for many healthcare institutions. However, the researchers warn that nearly half of the children who go to the ER for mental health issues do not get the necessary follow-up care they need after suffering a crisis, which can lead to worsening mental health problems, repeated visits to the emergency room, and serious mental and physical health risks.

Receiving timely follow-up mental health care within 30 days led to a 26% decreased risk of having a return ER visit, the data indicates.

The most common problems seen in the ER among children involve suicidal thoughts, severe behavior problems, and risk of self-harm or harm to others. Many of those children are under the age of 10.

The number of children and teens in emergency rooms for mental health issues was a significant concern before the COVID-19 pandemic. However, over the course of the pandemic, the crisis has deepened severely, mental health experts say. An increasing number of American children and teens feel the weight of isolation, concerns with school, and the burden of health problems among themselves and their family members.

Researchers recommend hospitals better coordinate with outpatient mental health care provdiders, in order to ensure children seen in the ER for mental health issues receive follow-up care within five days of being discharged.