The number of children and young adults visiting the emergency department for psychiatric concerns rose 28 percent over a four-year period, and visits having to do with #suicide more than doubled, according to a study published this week in the journal Pediatrics.
The findings amplify concerns that the mental-health care system is failing to meet the country’s needs, forcing people to rely on emergency rooms ill-equipped to deal with psychiatric concerns.
“If it’s a true crisis, the emergency department is really one of the only places we have,” said Luther Kalb, a coauthor of the study and assistant professor at the Kennedy Krieger Institute in Baltimore. “But it’s not the best place to get routine care.”
#JamesDonaldsononMentalHealth –
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space. #http://bit.ly/JamesMentalHealthArticle
Researchers examined national data on emergency department (ED) visits between 2011 and 2015.
They found the growth in visits was largely driven by adolescents and youth of color, but they’re not sure why. It could reflect a greater prevalence of #mentalillness, or it could be the result of greater awareness leading people to seek help, Kalb said.
Researchers also found only 16 percent of patients in the ED for psychiatric concerns saw a mental-health specialist. When the visits were for #suicide or self-harm specifically, that number went up to just 37 percent.
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“Even in a crisis, you’re not going to get the most qualified care there,” Kalb said.
Many EDs don’t have a psychologist or psychiatrist on staff, and there’s an overall shortage of mental-health providers in the country.
But as rates of suicide increase across the nation, and about one in 10 youth struggle with a serious psychiatric disorder, experts are increasingly turning to the ED as an opportunity to identify people at risk and get them help before they get worse.
A recent federally funded study found nearly a third of children ages 10 to 12 who were asked about suicidal thoughts in the emergency room were identified as at-risk — including 7 percent of those who had gone to the ED for physical complaints only.
The study authors said their results show how important it is to screen kids as young as 10 for #suicide risk.
But in many EDs, this type of screening doesn’t happen, meaning youth with psychiatric concerns can go home without mental-health care.
It also means the increase in psychiatric visits seen in recent years is an undercount. “When you actively screen for mental-health problems in the ED, you’re going to get a much higher number,” Kalb said.
A safety net, not an answer
By the time individuals visit the ED for mental-health concerns, they’re often in crisis, Kalb said.
People who don’t have insurance or cannot access mental-health professionals turn to the ED as a safety net when situations get particularly bad. The ED is obligated to treat all patients regardless of time of day, insurance status, or financial means.
According to the study, 5 to 7 percent of all pediatric ED visits in the United States are related to mental health or substance abuse.
“It’s become the de facto provider for mental-health crises,” Kalb said. “But it didn’t necessarily ask to take on that role.”
Kalb and his colleagues found more than half of all ED visits for #mentalhealth were longer than three hours. As the number of inpatient psychiatric beds has decreased in the last few decades, patients can wait days or even weeks to be admitted.
“They’re not safe to go home, so they’re stuck in this middle ground in the ED,” Kalb said.
Improving mental-health care in the ED
Ideally, Kalb said, there should be emergency facilities for mental-health care where patients can see a mental-health professional 24/7, and get fast-tracked to inpatient treatment if needed.
Some behavioral crisis centers provide this type of service, but they’re rare. The cost and complexity of starting such centers are barriers, Kalb said.
Simpler ways to improve care include training more ED doctors in mental-health response, from how to screen to what to do if someone is identified as high risk.
Researchers at the #NationalInstituteofMentalHealth have developed guidance on how to screen youth for #suicide in medical settings. Previous studies have shown universal suicide-risk screening in the ED can lead to a nearly twofold increase in #suicide risk detection.
Another promising effort is the use of telemedicine to have #mentalhealth specialists consult on emergency cases even if they cannot be with the patient in the ED.
“Now that we’re seeing #mentalhealth is a major, if not growing, issue in our society, we need to rethink the way we deal with crises,” Kalb said.
James Donaldson is a Washington State University graduate (’79). After an outstanding basketball career with WSU, he went on to play professional basketball in the NBA with the Seattle Supersonics, San Diego/L.A. Clippers, Dallas Mavericks, New York Knicks, and Utah Jazz. He also played for several teams in the European Leagues in Spain, Italy, and Greece, and he toured with The Harlem Globetrotters to wrap up his career. James was an NBA All-Star in 1988 while playing center for the Dallas Mavericks. In 2006, James was inducted into the Pac-10 Sports Hall of Fame and also the Washington State University Athletic Hall of Fame. In 2010, James was elected as a board member for the NBA Retired Players Association.
James frequently conducts speaking engagements (motivational, inspirational, educational) for organizations, schools, and youth groups.
In 2010, James was the recipient of the NBA Legends of Basketball ABC Award, awarded for outstanding contributions in Athletics–Business–Community.
He believes in being a role model for success and professionalism to the scores of young people to whom he devotes so much of his time. He currently serves on several boards and committees and is a member of many organizations.
James believes in developing relationships that create a “Win-Win” environment for everyone involved, and in being the best he can be!
For more information about James Donaldson or to request he speak at your event, contact him at:
www.StandingAboveTheCrowd.com
JamesD@StandingAboveTheCrowd.com
1-800-745-3161 (voicemail & fax)
James Donaldson is the author of “Standing Above The Crowd” and “Celebrating Your Gift of Life” and founder of the Your Gift of Life Foundation which focuses on mental health awareness and suicide prevention, especially pertaining to our school aged children and men.
If you’re interested in having James come and speak to your group of young adults, business entrepreneurs, aspiring political and community leaders, and athletic teams, please contact him at jamesd@yourgiftoflife.org and or leave a personal message for him at 1-800-745-3161. Keep up with him and read about how he is reaching out and making a difference in the lives of so many around the world at www.yourgiftoflife.org
