Why Pediatric Mental Health Emergencies Lead to Long Waits for Care: Understanding the Challenges and Solutions

Recent research highlights a pressing issue in pediatric mental health care. From 2018 to 2022, data showed that about one in three visits to Emergency Departments (EDs) for children’s mental health issues resulted in stays longer than 12 hours. Alarmingly, over one in eight kids waited more than 24 hours. Most of these prolonged stays were linked to suicidal thoughts or aggressive behaviors, emphasizing the severity of the youth mental health crisis.

Dr. Jennifer Hoffmann, the lead author of the study published in the Journal of American College of Emergency Physicians, stressed that many children end up in adult hospitals, which may not have the right resources for young patients. She suggested this situation shows a significant gap in mental health care for children and adolescents.

The study reviewed 5.9 million mental health visits by kids aged 5 to 17, with a shocking 1.4 million ending in transfer or admission. Surprisingly, only 1% of these visits were at children’s hospitals. Dr. Hoffmann pointed out the critical role of the federal Emergency Medical Services for Children (EMSC) program, which trains non-pediatric hospitals to provide better mental health care for the youth.

One concerning trend is that children with public insurance often face longer waits for psychiatric beds. This suggests inequalities in mental health access. Dr. Hoffmann noted that lower reimbursement rates for psychiatric services under public insurance compared to private insurance may worsen this disparity.

To tackle these challenges, Dr. Hoffmann proposed several solutions. These include expanding telehealth services, enhancing mental health support in schools, and integrating mental health care into regular doctor visits. Emerging models like psychiatric urgent care clinics and stand-alone psychiatric EDs could also provide much-needed help for the rising demand for youth mental health services.

As we navigate this mental health crisis, it’s essential to understand its historical context. Mental health issues in youth have always existed but have escalated in recent years, especially during and after the COVID-19 pandemic. A study from the CDC revealed a significant spike in anxiety and depression among children following the pandemic onset, highlighting the urgent need for systemic changes in mental health care.

In conclusion, improving access to mental health care for children requires a multifaceted approach. Continued funding and policy changes are crucial to ensure that all children can receive the care they need without the long waits currently faced in ERs.

For more information, visit Ann & Robert H. Lurie Children’s Hospital of Chicago or read the study: Hoffmann, J. A., et al. (2025). Pediatric Mental Health Boarding in US Emergency Departments, 2018-2022. JACEP Open. doi.org/10.1016/j.acepjo.2025.100180.

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Mental Health, Adolescents, Children, Emergency Medicine, Health Care, Hospital, Medicine, Research