Navigation Links
ER visits persist for children with mental health problems despite regular outpatient care
Date:5/31/2011

Johns Hopkins Children's Center scientists have found that having a regular outpatient mental health provider may not be enough to prevent children and teens with behavioral problems from repeatedly ending up in the emergency room. The study is published in the June 1 issue of the journal Psychiatric Services.

Analyzing more than 2,900 records of pediatric patients, ages 3 to 17, treated at the Hopkins Children's ER for mental health crises over eight years, the investigators found that 338 of them (12 percent) returned to the ER within six months of their initial visit. The majority of the ER visits stemmed from behavioral problems or minor psychiatric crises, such as disruptive classroom behavior, verbal altercations and running away, the researchers said. Only a few involved severe psychotic episodes (3 percent of the visits) or suicide attempts (10 percent). Most importantly, the researchers found, two-thirds of patients (220) reported having an outpatient mental health provider at both visits, and 288 (85 percent) reported at the second visit that they have a regular mental health provider.

The findings are concerning, the researchers said, because they may signal that patients are not actually getting the care they need on an outpatient basis.

Mental health experts have traditionally emphasized the importance of outpatient care in managing non-emergency cases and have urged connecting such patients to outpatient mental health programs. Most ERs are neither designed nor staffed to deliver effective, coordinated mental health care, the investigators said.

"We think of the ER as a 'front door to care,' but our findings suggest otherwise as a significant number of patients repeatedly seek care in the ER despite being connected to an outpatient provider," said lead author Emily Frosch, M.D., a pediatric psychiatrist at Hopkins Children's.

The findings, Frosch said, raise more questions than they answer, and researchers have only begun to untangle the complex reasons behind recurrent ER visits for non-emergency psychiatric problems.

"We need to understand why families who are already connected to outpatient providers continue to seek ER care, why providers send patients to the ER and what role, if any, ERs may play in the continuum of care for non-psychotic, non-suicidal patients," Frosch said. "It is possible that ERs fulfill an important function in that continuum for some patients."

The researchers said one possible explanation is that patient families face barriers to routine outpatient psychiatric care, including limited office hours. Families who have had a positive experience in the ER in the past may be simply choosing to return there for subsequent problems, the researchers say. Also, some families may also find ER care less stigmatizing than outpatient mental health services. Frosch added that ER visits may be driven by some outpatient providers who may not have sufficient resources for optimal care and instead send patients to the ER.

The Hopkins team said future studies should explore more specifically the link between outpatient care and ER visits.

"Perhaps the most critical questions to ask are 'When was the child's latest outpatient visit?' and 'What exactly transpired between that visit and their subsequent trip to the ER?'" Frosch said.


'/>"/>

Contact: Kim Hoppe
khoppe1@jhmi.edu
410-502-9430
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. Spine Surgeon from China Visits Panorama Orthopedics & Spine Center
2. Tony Blair Visits Pioneering Interfaith Malaria Initiative in Nigeria
3. Dying cancer patient visits to emergency departments can be avoided
4. Novel medical home program for pediatric patients, families cuts ER visits in half
5. SDI Reports: Emergency Room Visits Covered by Medicaid Increased 6% in 2009
6. ER Docs Predict Jump in Emergency Room Visits
7. Frequent Doctor Visits Help Diabetics Control Blood Pressure
8. “Toby Visits Mommy” -- A Great Book for Children and Parents
9. Virtual visits shrink the distance in stroke rehab
10. ER Visits Soaring for Prescription Painkiller Misuse
11. The ‘Hugging Saint' Amma Visits Dallas June 27-28, 2010, Offering Spiritual Upliftment to People of All Faiths
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... , ... June 26, 2016 , ... PawPaws brand ... new product that was developed to enhance the health of felines. The formula is ... The two main herbs in the PawPaws Cat Kidney Support Supplement Soft ...
(Date:6/25/2016)... ... 2016 , ... Austin residents seeking Mohs surgery services, can now turn to ... Dr. Russell Peckham for medical and surgical dermatology. , Dr. Dorsey brings specialization to ... fellowship in Mohs Micrographic Surgery completed by Dr. Dorsey was under the direction of ...
(Date:6/25/2016)... ... 25, 2016 , ... As a lifelong Southern Californian, Dr. Omkar Marathe earned ... the David Geffen School of Medicine at UCLA. He trained in Internal Medicine at ... fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had the opportunity ...
(Date:6/24/2016)... Los Angeles, CA (PRWEB) , ... June 24, 2016 , ... ... plastic surgery procedures that most people are unfamiliar with. The article goes on to ... known procedures, but also many of these less common operations such as calf and ...
(Date:6/24/2016)... ... June 24, 2016 , ... The ... in Dallas that it will receive two significant new grants to support its ... PHA marked its 25th anniversary by recognizing patients, medical professionals and scientists for ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... LONDON , June 23, 2016 ... environments  Oticon , industry leaders in ... the launch of Oticon Opn ™, the world,s ... world of possibilities for IoT devices.      ... Opn, Oticon introduces a number of ,world firsts,: ...
(Date:6/23/2016)... Research and Markets has announced ... Analysis (United States, China, Japan, Brazil, United Kingdom, Germany, ... offering. Surgical Procedure ... planners, provides surgical procedure volume data in a geographic ... in-depth analysis of growth drivers and inhibitors, including world ...
(Date:6/23/2016)... , June 23, 2016  The National Pharmaceutical ... joined the health policy research organization as its ... , MD, senior vice president and chief scientific ... representative on the NPC Board of Directors. ... that Mallinckrodt has joined us in support of ...
Breaking Medicine Technology: