Kids in mental health crises often end up stuck in emergency rooms (ERs) for longer than they should. A recent study revealed that about one in ten children on Medicaid who visit an ER for mental health issues spend three days or longer waiting for a hospital bed.
The most common causes for these extended stays? Severe depressive disorders and suicidal thoughts. Researchers found that in some states, like North Carolina and Florida, up to 25% of these cases result in kids being boarded in ERs for a week. Dr. John McConnell, who led the study at Oregon Health and Science University, emphasized the seriousness of this issue. “When kids arrive at an ER, about one in ten times, they’re stuck for several days,” he said.
This situation isn’t rare. Dr. Jennifer Havens, a child psychiatry expert at NYU, noted, “Having data like this helps us see the nationwide impact of the crisis.” The problem isn’t new, but it has worsened in recent years, particularly for children’s mental health cases. Many states struggle to provide adequate support for these kids.
Dr. Rebecca Marshall, a child psychiatry associate professor at OHSU, explained that as mental health challenges have surged among children, the systems meant to help have fallen behind. “There are simply not enough inpatient beds available,” she said. States like Oregon have shockingly low psychiatric bed counts—just 38 for the highest need cases.
Sadly, kids with serious mental health issues often have nowhere to go when they need help. “We’ve struggled for years to increase our capacity,” Marshall said. Children frequently wait for a bed to open up as others are discharged.
The lack of mental health services doesn’t just affect those on Medicaid. Children with private insurance face similar issues. Many families resort to ER visits, hoping for immediate help—and often find none available. “It’s disheartening for families trying to stabilize their child,” McConnell said, highlighting how tough the situation can be for parents.
Care in ERs is often inadequate. Most of these emergency rooms lack specialized child psychiatrists, and a child’s stay is usually confined to one small room, sometimes without windows. This can lead to deteriorating mental health, as these kids miss out on the social interactions and therapeutic activities they would get in a proper inpatient facility.
The underlying issue is a nationwide lack of mental health services, both inpatient and outpatient. Dr. Havens pointed out that proper outpatient care can help prevent mental health crises in the first place. Without these essential services, families face dire situations when seeking help.
Real change is needed. Communities and policymakers must prioritize mental health care for kids. It’s time to ensure that when children are in crisis, they receive not just urgent care, but the support they truly need.
For further insights, you can read the full study published in the JAMA Health Forum.
