Racial and Ethnic Disparities in Pediatric Mental Health-Related Emergency Department Visits

Abstract

Objectives: To test the hypotheses that (1) rates of mental health-related concerns presenting to pediatric emergency departments (ED) have increased (2) rates are increasing more in minority than nonminority youth.Methods: We performed a 5-year retrospective cohort study of youth with mental health-related ED visits using the Pediatric Health Information System. We calculated rates of mental health-related visits, in aggregate and by race/ethnicity. The Poisson model was used to generate incidence rate ratios of unique mental health-related visits each year using census data as the population denominator.Results: There were 242,036 mental health-related visits that met the inclusion criteria, representing 160,656 unique patients. Approximately 7% of unique patients had 3 or more mental health-related visits, differing by race/ethnicity (8.75% non-Hispanic [NH]-Black vs 7.01% NH-White; adjusted odds ratio 1.14 [1.03, 1.26]). Overall, there were 42.8 mental health-related ED visits per 100,000 US children. The NH-Black children had higher rates of visits per 100,000 children compared with adjusted relative risk,). Mental health-related visits increased from 2012 to 2016 (33.31 [32.92-33.70] to 49.94 [49.46-50.41]). Every racial/ethnic group experienced an increase in rate of presentation over the study period; Hispanics experienced a significantly larger increase compared with NH-White children (P < 0.05).Conclusions: Mental health-related ED visits among children are increasing overall, disproportionally affecting minority children. The NH-Black children have the highest visit rates, and rates among Hispanics are increasing at a significantly higher rate when compared with NH-Whites. These results indicate need for increased capacity of EDs to manage mental health-related complaints, especially among minority populations.

Systematic Review of Integration and Radicalization Prevention Programs for Migrants in the US, Canada, and Europe

“…Studies show that children from ethnical minorities experience high levels of isolation and socio-economic disadvantages. This can have a significant impact on their mental health, leading to issues such as depression, behavioral problems, anxiety disorders, post-traumatic stress, and other difficulties ( 40 ). There is one program that focuses on learning and understanding other cultures (13).…”

Practice Variation in Use of Neuroimaging Among Infants With Concern for Abuse Treated in Children’s Hospitals

“…Because 147 of 287 infants (51.2%) in our population with race coded as other were coded as Hispanic ethnicity, we merged race and ethnicity into a single variable, as has been done in prior literature assessing disparities in PHIS. 10 , 23 , 24 We recognize that race and ethnicity are distinct and that the resulting categories may not align with how families identify. The final race and ethnicity categories were American Indian non-Hispanic, Asian non-Hispanic, Black non-Hispanic, Hispanic, White non-Hispanic, and other or unknown non-Hispanic.…”

Trends in Positive Depression and Suicide Risk Screens in Pediatric Primary Care During COVID-19

“…Mental health concerns may be especially high for racially minoritized and lower income adolescents due to systemic racism and differential access to care. 3 , 4 , 5 The pediatric primary care office is an ideal place to screen for depression and suicide risk due to recommendations that adolescents visit annually for a well visit. 6 Both the American Academy of Pediatrics (AAP) and the U.S. Preventive Services Task Force (USPSTF) recommend routinely screening adolescents for depression 7 , 8 ; depression screeners often include questions about suicidality.…”