Rates of children visiting US mental health départements.
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| The sharp increase in children's visitation to US mental health departments |
Over the past 10 years, one in five children in the United States has developed a mental health disorder, and the rates of hospitalizations for children with suicidal ideation or attempts have more than double.
While rates of children’s visits to emergency departments (ED) in the United States of America have remained stable over the past ten years, rates of visits among the same group have skyrocketed due to mental health disorders by 60%, and intentional self-harm is at the forefront of these disorders at 329 %.
This prompted researchers at the emergency departments of Nationwide Children's Hospital in Columbus, Ohio, to conduct a research study to monitor the increase in these rates and their causes, and to evaluate the level of medical care services for mental and mental health conditions.
The researchers analyzed data on demographics for gender, age, and mental health conditions for patients aged 5 to 17 years, over ten years (2007-2016), to reveal the ability and preparedness of emergency medicine departments in US hospitals for such cases, using the Descriptive statistic techniques and tools concerned with collecting, organizing, summarizing, and presenting study data in a clear manner that contribute to understanding the nature of the research sample.
The researchers noted that the rate of visits of children and adolescents to psychiatric emergency departments in US hospitals increased by about 68%, especially in the age group from 15 to 17 years, 74% of whom were girls.
The study revealed an increase in anxiety disorders among children attending hospitals by 117%, impulse-control disorders by 111%, and the rate of visits for children with substance use disorder increased by more than 150%, while the rate of visits related to alcohol-related disorders decreased by 40%.
Charmaine Law - the study's lead researcher - explains to Al-Alam this sharp rise by saying: "In part, this is due to the increased awareness that medical assistance and resources are available; health counselors in schools, public service awareness campaigns, and others have contributed to raising awareness among all groups.
Adolescents may benefit from that, and seek care because of it.” She adds that the observed increase in the number of children with anxiety disorders, impulse control, and intentional self-harm could be a result of higher rates of diagnosis and awareness of health-seeking behaviors when needed.
For her part, Aya Maged, assistant professor of neurology at Alexandria University, explains that the increase in cases of intentional abuse among adolescents is usually caused by other psychological disorders, such as depression or personality disorders, but unfortunately, we also see cases of non-psychologically injured adolescents who harm themselves by She deliberately mimics others who do, noting that the study data did not explain the low rate of alcohol-related disorders, but attributed it to the possibility that some children replaced alcohol with other things, such as e-cigarettes, or marijuana, among others.
As for why girls are more likely to go to psychiatric emergency departments, Lu says: Extensive health care research looking for behavioral differences between girls and boys suggests girls seek medical and mental care at rates that outnumber boys.
For her part, Majid explains that the percentage of mental disorders in females is greater than that of males; The number of female depression patients is twice the number of males, and this may be attributed to the hormonal disorder, but the matter is purely theories, as she put it, adding that there are disorders in females that do not exist in males, such as postpartum depression disorder, and premenstrual disorder. Which could lead to suicide, she said.
Standard of care in non-urban areas.
The results of the study reflect the concerns of public health researchers that the increase in children’s visits to psychiatric emergency departments in hospitals may be the result of gaps in the mental health infrastructure in the United States of America, which means that the care provided to these children and adolescents may be substandard, and there may be aspects Lack of training and availability of emergency department staff to deal with mental health cases.
The results showed that less than half of US emergency departments are equipped to treat children with mental health disorders, and this percentage drops to one third in non-urban areas, and there is a significant shortage of caregivers in these areas in this specialty, especially among specialists in Providing mental care for children in particular, which is reflected in the accessibility of required medical care, as well as on the quality and quality of services provided in this field.
The study revealed that American children with mental disorders, particularly intentional self-harm and substance use disorders, often seek care in potentially less prepared facilities. Therefore, the study confirms the need to focus preparedness efforts and provide resources in the field of mental health in all emergency departments in hospitals, not just in pediatric emergencies.
Lu points out that if a child needs immediate medical care, the family usually seeks care in the nearest emergency department, and that families assume that he will be equipped to deal with the situation, but she goes on to say:
Not every emergency department has the necessary equipment to carry out the required care; The majority of children's hospitals with resources and access to pediatric specialists tend to be located in urban areas, and many families in the United States do not live close to these facilities and will seek care in local emergency departments, where the resources and ability to Level change readiness.
The study recommends conducting medical surveys and evaluations for all patients; To identify behavioral disorders that they may suffer from, which improves the quality of care for children and their psychological and mental well-being.
It calls for the necessity of concluding partnership programs with institutions that have specialized resources in this field; To contribute to equipping emergency departments with tools, staff, and resources to better deal with children's causes, especially those related to mental health.
Another method proposed in this framework is telemedicine mental health services, which can provide a platform for behavioral health professionals to communicate and screen cases, provide assistance for serious cases, and support communications to ensure ongoing care within the community, thus avoiding the cost of relocation, as well as avoiding Delays in providing care.
The results of the study indicate that telephone psychological counseling led to an increase in the rates of treatment of children with mental health disorders.
Tips and Recommendations.
Physicians stress the need for all emergency departments to be better prepared to care for children with mental health disorders, adding that this can happen through further education and training of all emergency department providers, use of toolkits and resources required to increase preparedness, and expansion of Scope of use of telehealth as a resource for service providers; To consult with specialists in emergency departments who have more resources and experience.
Doctors advise all parents to talk to their children, to be aware of any problems they may be experiencing. She adds that any family who feels the need to seek mental health care should contact their pediatrician and tell them their concerns, and go to the emergency department.
On the other hand, many doctors advise mothers and fathers, those who are about to get married or those who are waiting for the arrival of a new child, or those who already have children, to start reading about the principles of upbringing; A person is not born with the knowledge of how to raise, as cases of children and adolescents with mental disorders due to parents come to the psychiatric emergency.
As for the parents of children with mental or psychological illnesses, doctors advise them to understand the nature of the psychological disorder in their child well, and that every psychological disorder has a treatment or at least can become under control if the child or adolescent persists in treatment, whether pharmacological or psychological, and should not We surrender, or punish him for his sickness, just as we must not reject his sickness; It will be reflected in the way we deal with him, which may harm him even more.
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