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More kids are showing up in ERs with mental health crises

"The numbers are just staggering,” one researcher said.
Sliding doors of emergency room in hospital
Sliding doors of a hospital emergency room.Getty Images/Tetra images

An increasing number of children are showing up in U.S. emergency rooms in the throes of a mental health crisis, researchers reported Friday. And the increases are seen in minority children, in particular.

It’s not clear why, but the researchers say their findings are startling. They are seeing the same pattern across the country.

“It’s really disheartening. Community resources for mental health, especially for youth, are incredibly scarce,” said Dr. Anna Abrams, a pediatrician and researcher at Children's National Medical Center in Washington, D.C.

“It’s shocking, really.”

Abrams is a pediatric emergency health physician studying disparities in health care at Children’s.

“I started to see, in my clinical practice, increasing rates of mental health presentations,” she told NBC News.

She decided to see if the same thing was happening nationally. She looked at data from 45 children’s hospitals across the country from 2012 to 2016.

“We saw about a 55 percent increase over the entire period in mental health presentations,” Abrams said.

“Among white children, it was a similar number, about 48 percent. Then when we looked at non-Hispanic black population, the five year increase was 64 percent and among the Hispanic population, that five-year increase was 77 percent,” she added. “There were huge differences.”

Abrams and colleagues are presenting their findings to a meeting of the American Academy of Pediatrics that starts Friday.

In 2012, they found, 50.4 emergency department visits per 100,000 visits by children were for mental health-related concerns. By 2016, mental health was the cause for 78.5 emergency department visits per 100,000 children.

“When stratified by race and ethnicity, mental health-related visits to the nation’s emergency departments rose for non-Latino black children and adolescents at almost double the rate seen for non-Latino white children and adolescents,” said Dr. Monika Goyal, director of research in emergency medicine at Children’s.

“Access to mental health services among children can be difficult, and data suggest that it can be even more challenging for minority children compared with non-minority youths.”

The Centers for Disease Control and Prevention has also noted a rise in mental health problems, especially major depression, across the country as a whole and among teenagers in particular.

The CDC says one in five children ages 3 through 17 — about 15 million — have a diagnosable mental, emotional or behavioral disorder in a given year. But only 20 percent of them get diagnosed or receive care.

The average age of children being brought in for acute mental health crises was 13, the team found.

“One of our other analyses showed that during our study period, a non-Hispanic black child was 1.5 times more likely to present to an emergency department with a mental health complaint than a white child. The numbers are just staggering,” Abrams said.

Abrams said a combination of factors is likely causing the increases.

“We can speculate, but we can’t say for sure what is happening,” she said. In part, it could be due to the scarcity of mental health professionals who can help children. There’s also clearly a real increase in some mental health issues.

People are also talking more openly about depression, anxiety and other common mental health problems and that may make parents feel more comfortable about seeking help for their children, Abrams said. But it can be difficult to find specialized care.

“Large numbers of children never see a specialty healthcare provider,” she said. “Many, many times these kids need specialty mental health care that goes beyond the capability of a general pediatrician.”