Despite Psychiatric Care, Youths Continue to Visit ERs

Most youths who present to psychiatric pediatric ERs have an outpatient mental health provider

THURSDAY, June 9 (HealthDay News) -- Most youths who repeatedly present to an emergency department report having a connection to outpatient mental health care, according to a study published in the June 1 issue of Psychiatric Services.

Emily Frosch, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues assessed the correlation between patients' use of outpatient mental health care and repeated use of the pediatric psychiatric emergency department. Data were collected on 338 youths using the Pediatric Psychiatry Emergency Evaluation Forms, completed by child psychiatrists. Each of the youths returned to the emergency department of an urban general hospital within six months of an initial visit.

The investigators found that, at both the index and subsequent visits, behavior problems were the presenting complaint for more than 50 percent of the youths. A connection to an outpatient mental health provider was mentioned by 65 percent of the youths at both visits, whereas 9 percent did not report such a connection at either visit. Among youths who reported a connection with outpatient care at the index visit, the likelihood of reporting a connection was nearly five times higher at the second visit.

"Emergency settings are commonly thought to be 'front doors to care,' that is, points of access to mental health care. For the 65 percent of youths who reported a connection to a community mental health provider at both visits, the emergency department may instead be one element in a continuum of mental health services," the authors write.

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