The mental health of America’s youth is under duress, and it didn’t start with COVID-19. It’s a problem that’s been a much longer time coming.
In 2023, authors led by Mayo Clinic psychiatrist Tanner Bommersbach, M.D., MPH, examined trends in young people’s use of emergency departments. What they discovered was startling: From 2011 to 2020, the weighted number of pediatric ED visits related to mental health rose from 4.8 million to 7.5 million – an average increase of 8% a year. “Significant linearly increasing trends were seen among children, adolescents and young adults,” the investigators found, “with the greatest increase among adolescents and across sex and race and ethnicity.”
By 2020, mental health-related visits accounted for more than 13% of all pediatric ED visits – and then came COVID. Now, several years later, kids are still paying a heavy price.
“It’s not just a local problem. There’s a big boom of pediatric mental health crises nationwide,” said EMS physician Brandon Morshedi, M.D., DPT, FACEP, FAEMS, NREMT-P, FP/CCP-C, assistant medical director for Metropolitan EMS (MEMS) in Little Rock, Arkansas and a faculty physician in the Department of Emergency Medicine at the University of Arkansas for Medical Sciences. “Here in our service area, it was our second most common call type in every month of 2023, right behind ‘sick person.’ The causes are multifactorial, including a lack of adequate and efficient community outpatient mental health facilities and resources, and the emergency department seems to be where a lot of these kids end up.”
In the Little Rock area, where MEMS transports around 77,000 patients a year, that soaring pediatric mental health call volume started contributing to crunches in the emergency department: All the service’s mental and behavioral health patients under 18 had to be taken to a single facility, Arkansas Children’s Hospital (ACH), to be checked out and medically cleared before being transferred to a behavioral health center. “MEMS was transporting about two behavioral patients a day, and they were seeing a lot of additional behavior patients arriving by private vehicle and other EMS providers,” recalled MEMS Clinical Manager Mack Hutchison. Medics ended up delayed, and distressed kids endured long waits.
The situation wasn’t working well for anyone – but MEMS already had a solution in hand.