Mental health-related visits in a pediatric emergency department during the COVID-19 pandemic

Fernandez, Arnaud; Gindt, Morgane; Babe, Phillipe; Askénazy, Florence

doi:10.1186/s12245-021-00387-0

Cited by 9 publications

(4 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the seven research papers included, three discussed the rising incidence of pediatric BHE in the prehospital and ED settings [8][9][10] (Table 1). Two of those three articles [8,10] also show supporting evidence for an increased incidence of pediatric BHE during and after the COVID-19 pandemic. The remaining four research publications included in this review discussed prehospital interventions for pediatric BHE patients (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Prehospital Management of Pediatric Behavioral Health Emergencies: A Scoping Review

Zorovich,

Kothari,

Adelgais

et al. 2023

Cureus

View full text Add to dashboard Cite

Pediatric behavioral health emergencies (BHE) are increasing in prevalence, yet there are no evidence-based guidelines or protocols for prehospital management. The primary objective of this scoping review is to identify prehospital-specific pediatric BHE research and publicly available emergency medical services (EMS) protocols for pediatric BHE. Secondary objectives include identifying the next priorities for research and EMS protocol considerations for children with neurodevelopmental conditions. This is a scoping review comprised of a research literature search for publications from 2012-2022 and an internet search for publicly available EMS protocols from the United States. Included publications contain data on the epidemiology of pediatric BHE or describe prehospital management of pediatric BHE. EMS protocols were included if they had advisements specific to pediatric BHE.A total of 50 research publications and EMS protocols from 43 states were screened. Seven publications and four protocols were included in this study. Research studies indicated an increase in pediatric BHE over the last decade, but few papers discuss current prehospital management (n=4). Two EMS protocols were specific to pediatric BHE or pediatric agitation, and the other two EMS protocols focused on adult populations with integrated pediatric recommendations. All four EMS protocols encouraged nonpharmaceutical interventions prior to the use of pharmacologic restraints.Although there is a substantial rise in pediatric BHE, there is sparse research data and clinical EMS protocols to support best practices for prehospital pediatric BHE management. This scoping review identifies important future research aims to inform best practices for the prehospital management of pediatric BHE.

show abstract

Section: Resultsmentioning

confidence: 99%

Prehospital Management of Pediatric Behavioral Health Emergencies: A Scoping Review

Zorovich,

Kothari,

Adelgais

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Emerging evidence has demonstrated the negative impact of the COVID-19 pandemic on mental health in children, particularly among adolescents ( 15–17 ). During this time, children with previously diagnosed ADHD presented with more behavioral issues, more ADHD-related symptoms such as emotional difficulties and conduct behaviors and decreased psychological well-being ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Changes in real-world dispensing of ADHD stimulants in youth from 2019 to 2021 in California

Patel,

Chavan,

Rakovski

et al. 2024

Front. Public Health

View full text Add to dashboard Cite

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric neurobehavioral disorders in the U.S. Stimulants, classified as controlled substances, are commonly used for ADHD management. We conducted an analysis of real-world stimulants dispensing data to evaluate the pandemic’s impact on young patients (≤ 26 years) in California.MethodsAnnual prevalence of patients on stimulants per capita across various California counties from 2019 and 2021 were analyzed and further compared across different years, sexes, and age groups. New patients initiating simulants therapy were also examined. A case study was conducted to determine the impact of socioeconomic status on patient prevalence within different quintiles in Los Angeles County using patient zip codes. Logistic regression analysis using R Project was employed to determine demographic factors associated with concurrent use of stimulants with other controlled substances.ResultsThere was a notable reduction in prevalence of patients ≤26 years old on stimulants during and after the pandemic per 100,000 people (777 in 2019; 743 in 2020; 751 in 2021). These decreases were more evident among the elementary and adolescent age groups. The most prevalent age group on stimulants were adolescents (12–17 years) irrespective of the pandemic. A significant rise in the number of female patients using stimulants was observed, increasing from 107,957 (35.2%) in 2019 to 121,241 (41.1%) in 2021. New patients initiating stimulants rose from 102,754 in 2020 to 106,660 in 2021, with 33.2% being young adults. In Los Angeles County, there was an increasing trend in patient prevalence from Q1 to Q5 income quintiles among patients ≥6 years. Consistently each year, the highest average income quintile exhibited the highest per capita prevalence. Age was associated with higher risk of concurrent use of benzodiazepines (OR, 1.198 [95% CI, 1.195–1.201], p < 0.0001) and opioids (OR, 1.132 [95% CI, 1.130–1.134], p < 0.0001) with stimulants.DiscussionOur study provides real-world information on dispensing of ADHD stimulants in California youth from 2019 to 2021. The results underscore the importance of optimizing evidence-based ADHD management in pediatric patients and young adults to mitigate disparities in the use of stimulants.

show abstract

“…[3][4][5] From 2007 to 2016, emergency department (ED) visits for deliberate selfharm increased by more than 300%, with further increases observed during the COVID-19 pandemic. [6][7][8] Rates of hospital admission for patients with mental health conditions have increased concurrently. 9 When the need for inpatient psychiatric care exceeds bed availability, youth may experience mental health boarding, which has been defined by the Joint Commission as, "the practice of holding patients in the ED or another temporary location after the decision to admit or transfer has been made."…”

Section: Million Children and Adolescents In The Unitedmentioning

confidence: 99%

“…The growing prevalence of mental health conditions, in tandem with a national shortage of mental health professionals, has contributed to an increasing number of youth presenting to hospitals with mental health crises 3–5 . From 2007 to 2016, emergency department (ED) visits for deliberate selfharm increased by more than 300%, with further increases observed during the COVID‐19 pandemic 6–8 . Rates of hospital admission for patients with mental health conditions have increased concurrently 9 .…”

Section: Introductionmentioning

confidence: 99%

Healthcare quality during pediatric mental health boarding: A qualitative analysis

McCarty

Nagarajan

Halloran

et al. 2022

Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: Following initial evaluation and management, youth requiring inpatient psychiatric care often experience boarding, defined as being held in the emergency department or another location while awaiting inpatient care. Although mental health boarding is common, little research has examined the quality of healthcare delivery during the boarding period. Objective: This study aimed to explore the perspectives and experiences of multidisciplinary clinicians and parents regarding mental health boarding and to develop a conceptual model to inform quality improvement efforts. Design, Setting, & Participants: We conducted semistructured interviews with clinicians and parents of youth experiencing boarding. Interviews focused on experiences of care and perceived opportunities for improvement were continued until thematic saturation was reached. Interviews were recorded, transcribed, and analyzed to identify emergent themes using a general inductive approach. Axial coding was used to inform conceptual framework development. Results: Interviews were conducted with 19 clinicians and 11 parents. Building on the Donabedian structure-process-outcome model of quality evaluation, emergent domains, and associated themes included: (1) infrastructure for healthcare delivery, including clinician training, healthcare team composition, and the physical environment; (2) processes of healthcare delivery, including clinician roles and responsibilities, goals of care, communication with families, policies/procedures, and logistics of inter-facility transfer; and (3) measurable outcomes, including patient safety, family experience, mental health status, timeliness of care, and clinician moral distress. Conclusion: This qualitative study summarizes clinician and family perspectives about care for youth experiencing boarding. The conceptual model resulting from this analysis can be applied to implement and evaluate quality improvement endeavors to support this vulnerable population.

show abstract

Mental health-related visits in a pediatric emergency department during the COVID-19 pandemic

Cited by 9 publications

References 7 publications

Prehospital Management of Pediatric Behavioral Health Emergencies: A Scoping Review

Prehospital Management of Pediatric Behavioral Health Emergencies: A Scoping Review

Changes in real-world dispensing of ADHD stimulants in youth from 2019 to 2021 in California

Healthcare quality during pediatric mental health boarding: A qualitative analysis

Contact Info

Product

Resources

About