ILLINOIS — A survey of Illinois emergency departments revealed gaps in pediatric mental health care, according to findings published in the Journal of American College of Emergency Physicians Open. The study included 65 emergency departments across Illinois that participate in the Illinois Pediatric Facility Recognition Program.

Jennifer Hoffmann, an emergency medicine physician at Ann & Robert H. Lurie Children's Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine, described a key finding. "We identified that a key gap in emergency care was timely access to evaluation by a mental health professional, particularly those with pediatric-specific expertise." Hoffmann said. "Children experiencing a mental health crisis should not have to wait days in an emergency department for the care they need."

The study found that more than three-quarters of the surveyed emergency departments reported at least one child waited over three days for psychiatric care within the previous year. Seventy percent of respondents identified prolonged waits in the emergency department as a major challenge. Eighty-one percent of emergency departments identified the limited availability of services following the visit as a top barrier to optimal care. Fifty-six percent of emergency departments reported having mental health professionals available onsite, while 44% used telemental health services. Nearly two out of three responding emergency departments were in hospitals without a pediatric inpatient unit.

Eighty-eight percent of emergency departments reported screening children for suicide risk regardless of the visit's reason, but 56% consistently followed recommended steps to prepare families to prevent self-harm at home. Hospitals identified several needs. Eighty-two percent of emergency departments wanted safe activities and games to help children cope while waiting. Seventy-three percent wanted real-time information about available pediatric psychiatric beds statewide, and 72% desired a case manager to support families in connecting to follow-up care. Additionally, 65% of emergency departments sought a mechanism to escalate cases when staff struggled to find appropriate placement for a child.

Michelle M. Barnes, President of the Illinois Chapter of the American Academy of Pediatrics, noted that the survey findings highlight differences in pediatric behavioral health care processes and resources. "They point to the need for stronger coordination and greater consistency across Illinois' pediatric mental health care system," Barnes said. The Illinois Pediatric Facility Recognition Program, established in 1998, provides a state regulatory designation for pediatric emergency care and includes about half of Illinois' emergency departments. As of 2023, 23 states had similar programs. "Our findings provide a roadmap for improving pediatric mental health emergency care," Hoffmann said.