National Trends in Mental Health-Related Emergency Department Visits by Children and Adults, 2009–2015

Data Visualization

National Trends in Mental Health-Related Emergency Department Visits by Children and Adults, 2009–2015

January 15, 2020

By Sarah Axeen, PhD, Michael Menchine, MD, MPH, Genevieve Santillanes, MD, and Chun Nok Lam

Press Contact: Jason Millman (213)-821-0099

Public Health

Utilization of emergency department services for mental health-related visits can be challenging for hospitals to manage. This study showed mental health-related visits grew by 56 percent for pediatric patients and by almost 41 percent for adults.

This research was published in The American Journal of Emergency Medicine. The full study can be found here. A press release about the study is here.

A new study led by fellows at the USC Schaeffer Center shows mental health-related emergency department (ED) visits have increased substantially since 2009, a trend driven by large increases in adolescent and young adult visits to the emergency room for behavioral health-related diagnoses.

The study showed that for patients between 10 and 25 years old, annual growth rates for behavioral health-related visits were double those of older age groups.

Trends in Proportion of ED Visits With Mental Health Discharge Diagnosis, by Age

Abstract

Objectives

Examine trends in mental health-related emergency department (ED) visits, changes in disposition and length of stay (LOS), describe disposition by age and estimate proportion of ED treatment hours dedicated to mental health-related visits.

Methods

Trends in ED Visits Resulting in Admission or Transfer, 2009-2015

Retrospective analysis of ED encounters in the National Hospital Ambulatory Medical Care Visit Survey with a mental health primary, secondary or tertiary discharge diagnosis from 2009 to 2015. We report survey-weighted estimates of the number and proportion of ED visits that were mental health-related and disposition by age and survey year. We estimate the proportion of ED treatment hours dedicated to mental health-related visits. We analyze trends in disposition and LOS for mental health and non-mental health-related visits using multivariate regression analysis.

Results

Mental health-related ED visits increased by 56.4% for pediatric patients and 40.8% for adults, accounting for over 10% of ED visits by 15–64 year-olds and nearly 9% by 10–14 year-olds in 2015. Mental health-related visit disposition of admission or transfer declined from 29.8% to 20.4% (p < .001); predicted median ED LOS for admissions or transfers increased from 6.5 to 9.0 hours while median LOS for discharges was stable at 4.4 hours. During the study period, mental health-related visits accounted for 5.0% (95% CI 4.6–5.3) of all pediatric and 11.1% (95% CI 11.0–11.3) of adult ED treatment hours.

Conclusions

Mental health-related visits account for an increasing proportion of ED visits and a considerable proportion of treatment hours. A decreasing proportion of mental health-related visits resulted in inpatient disposition and ED LOS increased for admissions and transfers.

Citation: Santillanes, G., Axeen, S., Lam, C. N., & Menchine, M. (2019). National trends in mental health-related emergency department visits by children and adults, 2009–2015. The American Journal of Emergency Medicine.