We might think the one place where kids who self-harm could finally get help would be in an emergency room admitting them for injuries due to self-harm. Apparently not. A new study shows those kids who self-harm are released back to the community without a mental health evaluation. And a large portion of those kids receive no follow up care in the month after the episode.
Self-harm, like cutting or even suicide attempt, is one of the most common reasons for an emergency room visit for adolescents. Most of these kids, up to 90%, meet the criteria for at least one psychiatric disorder and most often that is a mood disorder. The National Institute for Clinical Excellences has put forth a standard that all patients presenting to emergency departments with self-injury should receive a mental health evaluation prior to discharge.
In order to study the level of mental health care in emergency rooms, Jeff Bridge, PhD, principal investigator in the Center for Innovation in Pediatric Practice of The Research Institute at Nationwide Children’s Hospital and his team looked at Medicaid Extract files through the country for children ages 10 to 19. They found that most kids admitted for self-harm were discharged to the community rather than inpatient care. Only 39% received an assessment.
“Our findings suggest that the decision to provide emergency mental health assessment is dictated less by the clinical characteristic of individual patients and more by staffing patterns or established emergency department evaluation protocols,” said Dr. Bridge. “This study highlights the need for strategies to promote emergency department mental health assessments, strengthening the training of physicians in pediatric mental health and adolescent suicide prevention and timely transitions to outpatient mental health care.”
Source: MedicalNewsToday, Journal of the American Academy of Child & Adolescent Psychiatry
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