A recent study from Oregon Health & Science University highlights that thousands of children experiencing mental health crises are being held in emergency rooms for several days due to a lack of appropriate treatment facilities, with over 30,000 cases in 2022 involving stays of 3 to 7 days.

The study, analyzing Medicaid claims from 44 states, found that about 12% of pediatric mental health emergency visits result in prolonged ER stays, especially for children with suicidal thoughts, attempts, or severe depression.

Children in mental health crises often cannot be discharged because there are no available hospital beds or residential facilities, leading to extended stays and inadequate care.

Experts point out that the core issue is a fragmented healthcare system that treats mental health as secondary, calling for clearer accountability and measurable outcomes to address the crisis.

Despite investments like Oregon’s $130 million fund for community-based mental health facilities, demand continues to outpace supply due to fragmented and short-term funding approaches.

Boarding rates for children in ERs vary widely by state, from 2.7% in Arkansas to 27.3% in Iowa, with Oregon’s rate slightly above the national average, indicating regional disparities in access to mental health services.

Oregon’s mental health initiatives, including parity laws and expansion plans, have fallen short, leaving systemic issues unaddressed and accountability unclear.

The nationwide shortage of inpatient mental health beds and insufficient capacity for children in crisis are systemic gaps that contribute to the ongoing problem.

Experts emphasize the need for a better continuum of care and policy reforms to support Medicaid and insurance providers in delivering adequate mental health services for youth.

At OHSU Doernbecher Children’s Hospital, pediatric psychiatric visits have nearly tripled since 2016, with children often arriving after reporting suicidal or depressive symptoms but finding no psychiatric beds available.

The number of psychiatric consultations for children at the hospital has tripled from 150 in 2016 to 453 recently, reflecting increased demand and capacity challenges.

Children in ERs often experience discomfort and agitation due to non-therapeutic environments, which can worsen their mental health and complicate treatment.

Boarding in emergency departments negatively impacts children’s health, families, and hospital staff, with healthcare providers feeling demoralized as children’s conditions can worsen without proper treatment.

Current emergency room stay times for mental health patients significantly exceed the recommended maximum of four hours, highlighting a critical gap in timely and proper mental health care for children.