Pulsara Blog

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.

With a new protocol and Pulsara, Metropolitan Emergency Medical Services can now transport eligible pediatric behavioral health patients directly to behavioral health facilities—resulting in a 44% decrease of pediatric behavioral health patients transported to the ED. 

Metropolitan Emergency Medical Services (MEMS) is a public, non-profit EMS entity serving Little Rock, Arkansas, and its surrounding counties. The organization’s service area covers approximately 1,800 square miles and nearly half a million Arkansans. MEMS transports around 77,000 patients each year. In 2020, MEMS adopted Pulsara to improve communication with area hospitals for time-sensitive emergencies such as stroke, STEMI, and trauma. 

In the wake of the COVID-19 pandemic, MEMS faced a new challenge: a growing number of pediatric behavioral health cases. Between 2022 and 2023, mental health calls accounted for 10% of MEMS’ overall call volume, with a noticeable surge in pediatric mental health cases. MEMS was transporting every behavioral health patient under 18 to Arkansas Children’s Hospital, creating a bottleneck in the emergency department as patients wait to be transferred to a behavioral health facility. Mack Hutchison, Clinical Manager for MEMS, explains: “Many of these patients do not need medical clearance and can occupy a room in the ED for up to 24 hours before a bed is found for them at a behavioral health facility.” Hutchison had an idea: what if those who didn’t need medical clearance could be routed directly to a behavioral health facility, relieving pressure on the ED and getting patients care more quickly?

Download the case study or read on to learn more!

The newly expanded platform allows first responders and healthcare providers to support behavioral health patients via telehealth and streamlined transfers. 

Bozeman, Mont., March 22, 2022 — Pulsara, the leading mobile telehealth, communication, and logistics platform that unites healthcare teams and technologies across organizations during dynamic events, recently released a dedicated behavioral health patient type allowing EMS crews, hospital teams, and other healthcare organizations to better support behavioral health patients. EMS or other first responders can now directly connect with behavioral health facilities, teams, or individuals through live group video and audio calling to receive help in determining the most appropriate treatment for the patient. For teams working with patients who need enhanced behavioral health services, this new patient type helps streamline placement to a more appropriate facility. Utilizing this new functionality on the Pulsara platform, clinicians can quickly facilitate appropriate real-time treatment for patients, help relieve overcrowded healthcare facilities, and save time, money, and resources by avoiding unnecessary and extended ED visits.