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Child and Youth Emergency Mental Health Care
A National Problem

Authors: Janice L. Cooper and Rachel Masi
Publication Date: July 2007

This is an excerpt from the full brief.

High levels of unmet need for community-based children’s mental health services persist. Over the past decade child mental health-related visits to hospital emergency departments have significantly increased. Combined these factors suggest that emergency departments have become substitute sources of care for routine mental health problems. Indeed, non-emergency mental health care accounts for the increases in mental health-related visits to hospital emergency departments.

Increases in emergency use rates for mental health care by children and youth are emblematic of problems with access to community-based mental health services and supports. These visits further stretch an overextended emergency health care system. Emergency departments are poorly equipped to address the mental health needs of children, youth, and their families who seek psychiatric attention. While they encounter challenges meeting the need for pediatric and adolescent services, they are even less prepared to provide pediatric and adolescent mental health care. This issue brief reviews the state of mental health services for children and youth who visit hospital emergency departments for mental health-related reasons and provides an overview of the challenges associated with mental health-related emergency department visits. It discusses the policy implications of using emergency department services for mental health reasons for children and youth and makes recommendations for policy action.

Increases in the use of hospital emergency departments point to the lack of availability of community-based services. This situation raises many concerns:

  1. Inappropriate use of emergency departments for routine mental health care
  2. Inefficient use of resources
  3. Cost shifting due to the lack of community-based mental health services
  4. Lack of capacity and competency in emergency departments to appropriately screen, treat, and refer children and youth with mental health-related problems
  5. Potential to compromise quality and lead to poor health and mental health outcomes