Citation

Karpman HE, Frazier JA, Broder-Fingert S. Pediatrics 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American Academy of Pediatrics)

DOI

10.1542/peds.2022-058832

PMID

36775800

Abstract

In this issue of Pediatrics, Hoffman et al1 present follow-up rates after a pediatric mental health emergency department (ED) visit using a Medicaid claims data set. Their analysis reveals a follow-up rate of 56% for any outpatient mental health visit within a 30-day window. If we consider an ED visit for mental health care a clear indicator of need for specialty mental health care, this study suggests that only about half of the young people who need such care receive it.

Although the authors rightly focus their discussion on this striking gap between need and access to mental health care, their analysis uncovers other important indicators of a pediatric mental health system of care in crisis. Twenty-seven percent of all children in this sample returned to the ED for mental health-related symptoms within a 6-month period, implying that even those who did receive outpatient treatment were not adequately held in that setting. Twenty eight percent of children presented with >4 distinct mental health diagnoses, suggesting poor diagnostic specificity or perhaps inadequate diagnostic categories to characterize their needs. Twenty percent spent >48 hours in the ED for their index mental health visit, demonstrating that the kind of follow-up care required was unavailable. The analysis by Hoffman et al, in all areas, documents critical problems in our pediatric outpatient mental health treatment system...

Language: en