The Senior Science and Policy Advisor for the Annapolis Coalition, Dr. Michael Hoge, has been focused on the national crisis in child and adolescent mental health. In collaboration with Connecticut colleagues at the Child Health and Development Institute and the Yale School of Medicine, he has authored a new article, Emergency Department Use by Children and Youth with Mental Health Conditions: A Health Equity Agenda. Among a variety of issues, the article addresses the workforce dimensions of this crisis.
Based on a comprehensive review of the literature, which was conducted prior to the pandemic, the authors concluded that rates of utilization have been increasing dramatically and children and youth are often sent to Emergency Departments (EDs) for reasons judged to be clinically inappropriate. With respect to health inequities, the rate of increased utilization appeared much greater among African American and Latinx children and youth than White children and increased for the publicly insured and uninsured, while declining for the privately insured.
Another form of health inequity reported was that only a minority of the children and youth seen in EDs were evaluated in these settings by a behavioral health professional. The authors identify strategies to address this overall crisis, including standards development, systems development, workforce development, ED quality improvement, and research and evaluation. The recommended workforce strategies involve strengthening the behavioral health, primary care, and school workforce through increased training in prevention and intervention with mental health crises among children and youth; assessing and addressing the adequacy and training of the ED workforce to evaluate and treat children and youth with mental health conditions; and increasing the education of parents and guardians about ED mental health services and alternatives to EDs.
The article, which will be published in the Community Mental Health Journal, is accessible now online at no charge via this link.