The rise in pediatric mental health cases has become a pressing concern, with overwhelmed emergency departments struggling to meet the increasing demand for care. According to a Kaiser Family Foundation article, young adults (ages 18-24) reported a significant increase in anxiety and depression symptoms in 2023, surpassing older adults. The challenges faced by young adults during the COVID-19 pandemic, such as school and university closures, remote transitions, and social isolation, likely contributed to this concerning trend of poor mental health. This trend has led to overwhelmed emergency departments struggling to provide adequate care and resources for children and adolescents needing mental health services. 

Below, we will explore the insights shared during The Pediatric Pandemic, Managing and Advancing the Care of Youth with Behavioral Health Concerns in the ED webinar, shedding light on the factors contributing to this surge and proposing potential solutions. 

1. The Impact of Early Life Experiences:

During the webinar, Dr. Mark Alter, SVP and Chief medical officer of Acute Care at Array Behavioral Care stated, “Early life experience can not only affect individuals but can be transmitted across generations,” emphasizing the significance of addressing mental health concerns early on. According to a study published in JAMA Network, adverse childhood experiences (ACEs), such as trauma, neglect, and abuse, significantly increase the risk of mental health disorders in childhood and later in life. These experiences can have intergenerational effects, highlighting the need for early intervention and support to break the cycle of mental health challenges. 

Early intervention programs and initiatives that promote healthy environments and support families can contribute to better mental health outcomes for children. Investing in programs that address adverse childhood experiences (ACEs) can help break the cycle and prevent the intergenerational transmission of mental health challenges.

2. Escalating Numbers and Complexity:

The significant increase of 130% in pediatric behavioral health patients, as mentioned by Kyle Finucane, the Director of Behavioral Health at Chester County Hospital (Penn Medicine), reflects a growing need for mental health services among young adults. According to CDC data, from March 2020 to October 2020, mental health-related emergency department visits increased 24% for children ages 5 to 11 and 31% for those ages 12 to 17 compared with 2019 emergency department visits. This trend is not exclusive to the pandemic period—it was already underway before COVID-19. 

3. Barriers to Accessing Care:

Limited access to mental health services often leads individuals to seek help in emergency departments, exacerbating the overwhelming situation. Overcoming barriers such as lack of insurance coverage, provider shortages, and insufficient community-based resources is essential. 

As Scott Baker, VP of Sales at Array Behavioral Care, points out, “... the longer that the bed is held, despite the fact that the patients oftentimes are not getting better, means that care is being delayed or deferred from other patients, whether they be adult health medical or adult behavioral patients. And that deferred care is just scary, but it has a snowball effect.” This indicates the urgent need to address the strain on emergency departments caused by the increased demand for pediatric mental health services.

4. Early Detection and Diagnosis:

Solome Tibebu, Founder and CEO of Going Digital: Behavioral Health Tech, shared her personal experience of struggling with severe obsessive-compulsive disorder (OCD) and panic attacks during her youth. She highlighted the need for early detection and accurate diagnosis, as misdiagnoses or delayed diagnoses can exacerbate mental health issues and lead to unnecessary emergency department visits. Early detection allows for timely access to appropriate treatment and support, reducing the likelihood of crisis situations.

5. Insufficient Resources and Bed Availability:

Dr. Mark Alter highlights the shortage of psychiatric beds for children needing inpatient care, adding strain to emergency departments. Additionally, Dr. Ameer Mody, Director of ED Clinical Informatics at Children’s Hospital Los Angeles, stresses the importance of exploring alternative options. He suggests that removing 12-year-olds from their familiar environment and placing them in an emergency department or inpatient facility may not yield better outcomes. Instead, he advocates for an intermediate solution, such as intensive outpatient therapy that provides tailored support while allowing the patient to remain in their familiar surroundings.

Dr. Mody emphasized the vital role of policymakers in recognizing and addressing the profound impact of adverse childhood experiences (ACE) and social determinants of health. By incorporating crucial factors into policymaking, policymakers have the power to shape a healthcare system that is both supportive and effective, tackling the root causes of behavioral health challenges. 

To watch the recording of this webinar, click here.