Experiences of Pediatricians Caring for Children and Adolescents With Mental Health Needs in the Emergency Department, 2022.

OBJECTIVES

Despite the ongoing mental health crisis among US youth and the critical role that pediatricians caring for children and adolescents in emergency departments (EDs) play, there are limited studies capturing these pediatricians' concerns, experiences, and needs.

METHODS

National weighted survey data on mental health care were collected in 2022 from the American Academy of Pediatrics Pediatrician Life and Career Experience Study (PLACES) participants (response=67%). We analyzed responses from 115 pediatricians caring for children and adolescents in the ED. Participants reported perspectives on: (a) overall pediatric mental health concerns; (b) frequency of mental health presentations; (c) experience prescribing psychotropic medication; and (d) referral difficulty. We systematically examined open-ended responses on the most pressing mental health needs.

RESULTS

Eighty-four percent of pediatricians caring for children and adolescents in the ED reported that mental health is a significant problem for youth in their community. Nearly all (98%) reported caring for children and adolescents with mental health conditions in the past month. Many reported daily encounters with pediatric patients experiencing mental health conditions, including anxiety, depression, and suicidal ideation. One in five reported prescribing psychotropic medication in the past year, none of whom reported being "very" comfortable doing so. One in five said resources to care for children and adolescents with mental health conditions were very or moderately available in their community. Open-ended responses (n=79) highlighted the urgent need for resources and solutions at the national level.

CONCLUSIONS

Pediatricians in the ED have significant concerns about child and adolescent mental health in their communities, and many see youth with anxiety, depression, and suicidal behavior daily. Findings underscore a need for more support for pediatricians in the ED and innovative solutions to improve child and adolescent mental health.