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ObjectiveTo explore demographic predictors of Emergency Department (ED) utilization among youth with a history of suicidality (i.e., ideation or behaviors).MethodsElectronic health records were extracted from 2017 to 2021 for 3094 8–22 year‐old patients with a history of suicidality at an urban academic medical center ED in the Mid‐Atlantic. Logistic regression analyses were used to assess for demographic predictors of ED utilization frequency, timing of subsequent visits, and reasons for subsequent visits over a 24‐month follow‐up period.ResultsBlack race (OR = 1.45, 95% CI = 1.11–1.92), Female sex (OR = 1.59, 95% CI = 1.26–2.03), and having Medicaid insurance (OR = 1.71, 95% CI = 1.37–2.14) were associated with increased utilization, while being under 18 was associated with lower utilization (<12: OR = 0.38, 95% CI = 0.26–0.56; 12–18: OR = 0.47, 95% CI = 0.35–0.63). These demographics were also associated with ED readmission within 90 days, while being under 18 was associated with a lower odds of readmission.ConclusionsAmong patients with a history of suicidality, those who identify as Black, young adults, patients with Medicaid, and female patients were more likely to be frequent utilizers of the ED within the 2 years following their initial visit. This pattern may suggest inadequate health care access for these groups, and a need to develop better care coordination with an intersectional focus to facilitate utilization of other health services.

Objective: To understand patterns of Emergency Department (ED) utilization among pediatric patients at high-risk for suicide. Methods: Electronic health records were extracted for N=3,094 patients aged 8 - 22 years who screened positive for suicide risk and/or presented with a suicide-related chief complaint within an academic medical center ED. Regression analyses were used to assess for demographic or clinical characteristics which were associated with frequency of ED utilization, timing of subsequent visits, and reasons for subsequent visits over a 24-month follow-up period. Results: Female sex (OR=1.72), Black race (OR=1.53), having Medicaid insurance (OR=1.59), and having a developmental disorder (OR=1.39) were associated with increased ED utilization, while being under 18 was associated with lower utilization (&lt;12 OR=0.38, 12 - 18 OR=0.46). Female sex, Black race, and Medicaid insurance were also associated with greater odds of ED readmission within 90 days. Having Medicaid insurance or a diagnosis of a developmental or mental health disorder were associated with greater odds of returning to the ED for a subsequent mental health crisis. Conclusions: Patients over the age of 18, with Medicaid, who identify as Black, and female patients showed a greater odds of being frequent utilizers of the emergency room within the 2 years following their initial ED visit. This pattern may suggest inadequate health care access for these groups, and a need to develop better care coordination to facilitate utilization of other health services.