Trends in Pediatric Mental Health‐Related Emergency Department Visits During the School Year and School Breaks

BACKGROUND: We examined patient and visit trends in pediatric emergency department (ED) usage during the school year and summer breaks before, during, and after the COVID-19 pandemic. METHODS: We extracted data on mental health-related visits to the ED of an academic medical center from 2018 to 2023 among youth aged 5-18. Data were visualized, and overall visit frequency was modeled via piecewise linear regression. Odds ratios were estimated for characteristics associated with suicidal ideation and inpatient admission. RESULTS: A total of n = 2536 unique individuals had 3358 ED encounters resulting in a mental health-related diagnosis. Visit frequency was flat from August 2018 to a nadir in August 2020, followed by an increase. Female patients had increased odds of ED visits (OR = 1.45; 95% CI: 1.24-1.69) compared to males. Visits during school breaks were associated with increased odds of inpatient admission compared to visits during school sessions (OR = 1.30; 95% CI: 1.08-1.56). IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Schools are an important site for mental health promotion and can collaborate with EDs and community providers to support students before breaks. CONCLUSIONS: Students may experience a decrease in school-related stress during breaks, but a lack of access to school-based mental health support may be one factor related to increased ED visits requiring inpatient admissions.