Survey Finds Increase in ED Psychiatric Visits for Underinsured Kids

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Hospital emergency departments have seen a recent increase in the number of pediatric patients who are receiving psychiatric care, and unfortunately, those that are being treated the most are those either without insurance or who are receiving Medicaid.

In a presentation to the American Academy of Pediatrics (AAP) National Conference and Exhibition being held in Boston, lead study author Zachary Pittsenbarger MD notes that over an eight year period between 1999 and 2007, 279 million pediatric patients were seen in emergency departments across the country. Almost three percent of those were for psychiatric visits, representing an increase in mental health diagnoses among kids.

The data was collected from the National Hospital Ambulatory Medical Care Survey.

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The most common mental health conditions that occur in children include depression, anxiety, behavior disorders and attention deficit hyperactivity disorder. Depression, for example, occurs in as many as one in ten children between the ages of six and twelve, according to the American Psychiatric Association. ADHD often develops before age seven, but is typically diagnosed between ages eight and ten.

Without treatment, psychiatric problems can lead to school failure, alcohol or other drug abuse, violence or even suicide.

Insurance status was one of the criteria measured in the study. Those considered underinsured, meaning they did not have health insurance or they were covered by Medicaid public insurance, accounted for 54% of those pediatric ED visits in 2007, up from 46% in 1999. Medicaid does provide some mental health benefits, but services and costs vary by state. Some states will cover services by a licensed psychologist or social worker, but others will only cover services within clinics, hospitals, or community health centers.

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"It has been found previously that the publicly insured have fewer treatment options and longer wait times for psychiatric disorders when not hospitalized," Dr. Pittsenbarger said. "This new finding argues that limited outpatient mental health resources force those patients to seek the care they need in the emergency department."

Source Reference: "Disproportionately Increasing Psychiatric Visits to the Pediatric Emergency Department Among the Underinsured," provided by American Academy of Pediatrics, presented October 14, 2011.

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