'The volume is astronomical': ED physicians call for more support to grapple with mental health crisis

Every year, an estimated half a million children are evaluated for psychiatric emergencies in emergency departments — a figure that has increased over the past decade — that are unequipped to handle the crisis, three leading medical groups said in a new policy statement

The joint policy statement was published Aug. 16 by the American Academy of Pediatrics, the American College of Emergency Physicians and the Emergency Nurses Association.

Already, resource strain and capacity backlogs are a significant problem in EDs across the country, Mohsen Saidinejad, MD, lead author of the policy statement and a professor of emergency medicine and pediatrics at the David Geffen School of Medicine at UC Los Angeles, told NBC News. "Now we're adding to this a huge element of an increasing number of children — younger and younger, by the way, as young as five — who are coming in with mental health complaints," Dr. Saidinejad said. 

This has been the experience of Willough Jenkins, MD, medical director of emergency and consultation liaison psychiatry at San Diego-based Rady Children's Hospital, who was not involved in the new policy statement. She told NBC that in the past, there would be around 30 kids a month needing psychiatric care in the ER. In recent years, it's about the same number — on a daily basis. 

"The volume is astronomical, and I don't know that people fully understand how many people are struggling," Dr. Jenkins said. "The crisis is only getting worse. … It's not getting better." 

The three medical groups say more action needs to be taken at the community level to support emergency departments in dealing with the pediatric mental health crisis. The policy outlines a number of recommendations including the development of community-based teams to respond to mental health crises in schools, homes and physicians' offices; adding trained mental health professionals to ED teams; and more resources for ED staff to recognize and provide care to groups who may be at higher risk of mental and behavioral health concerns. 

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