Trends in Visits and Costs for Mental Health Emergencies in a Pediatric Emergency Department, 2010–2016

Jennifer A Hoffmann*, Anne M. Stack, Mihail Samnaliev, Michael C. Monuteaux, Lois K. Lee

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Objective: Analyze trends in visit numbers, length of stay (LOS), and costs of pediatric mental health emergency department (ED) visits over time. Methods: We conducted a cross-sectional, time-series analysis from 2010 to 2016 of mental health visits, identified by billing diagnosis codes, among children 5 to 18years old in a tertiary pediatric ED. We used Poisson regression to analyze trends in rates of mental health visits, patient-hours, and visits with LOS ≥ 24hours. We used time-series analysis to trend median costs per visit. Results: From 2010 to 2016, there were 197,982 ED visits and 13,367 (6.7%) mental health visits. Mental health visits increased by 45% (from 1462 to 2119), compared to a 13% increase in non–mental health visits. The rate of mental health visits increased from 5.6 to 7.1 per 100 ED visits and increased 5.5% annually, compared to –0.4% annually for non–mental health visits (incidence rate ratio [IRR], 1.06; 95% confidence interval [CI], 1.05–1.07). Mental health patient-hours increased 186%, compared to an 18% increase in non–mental health patient-hours. The rate of mental health visits with LOS ≥ 24hours increased from 4.3 to 18.8 per 100 mental health visits and increased 22% annually (IRR, 1.22; 95% CI, 1.19–1.26). Median costs per visit increased by $38 per quarter (95% CI, $28–$48). Conclusions: Rates of mental health visits, patient-hours, visits with LOS ≥ 24hours, and visit costs are increasing over time. Additional hospital and community resources are needed to address rising ED utilization for mental illness in children.

Original languageEnglish (US)
Pages (from-to)386-393
Number of pages8
JournalAcademic Pediatrics
Issue number4
StatePublished - May 1 2019


  • emergency care
  • mental health
  • pediatrics
  • resource utilization

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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