Pediatric Emergency Department Visit Follow-Up

A recent study examined rates of follow-up outpatient care for children discharged from emergency departments after mental health care visits.

Study participants were 28,551 children ages 6 to 17 enrolled in Medicaid who visited emergency departments for mental health care between January 2018 and June 2019. The study found that 31.2% of participants received outpatient care within 7 days of discharge and 55.8% received care within 30 days. The most common diagnoses were depressive disorders (39.1%); disruptive, impulse control, and conduct disorders (25.0%); and trauma and stressor-related disorders (14.2%).

Non-Hispanic Black children were less likely than White and Hispanic children to have follow-up visits within seven days of discharge. Children covered under fee-for-service Medicaid were also less likely to receive follow up within seven days. Children who had received mental health outpatient care in the previous year were most likely to receive timely follow-up care after an emergency department visit.

Receiving follow-up care within 30 days of discharge from an emergency department was associated with a 26% decreased risk of return within 5 days of the initial visit. Among all children studied, 26.5% returned to an emergency department for mental health care within six months of their initial visit.

The findings from this study highlight the importance of timely access to mental health services for children following an emergency department discharge. The authors note that children seen in an emergency department are likely to have less severe clinical symptoms and greater family support, which may have affected the outcomes in this study.

Hoffmann, J. A., Krass, P., Rodean, J., Bardach, N. S., Cafferty, R., Coker, T.R., Cutler, G.J., Hall, M., Morse, R. B., Nash, K. A., Parikh, K., Zima, B. T. (2023).  Follow-up After Pediatric Mental Health Emergency Visits. Pediatrics, 15(3). 10.1542/peds.2022-057383