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WMJ Vol 123 Issue 6: Optimizing Pediatric Patients Attainment of Outpatient Mental Health Services Following Emergency Department Care

ABSTRACT Introduction: Psychiatric emergency department (ED) visits among youth have risen in the United States in recent years. A major factor contributing to this increase is the lack of accessible inpatient and outpatient services, making the ED a safety net for mental and behavioral health emergencies. This study sought to assess outpatient mental and behavioral health care after ED discharge and understand barriers and facilitators that caregivers encounter when attaining outpatient care. Methods: This was a mixed methods study conducted at a tertiary care pediatric ED. Patients ages 3 to 17 years seen for mental health concerns received a social work consult and were contacted 1 week after the ED visit by the mental and behavioral health navigator as part of ongoing quality improvement efforts. Descriptive data included types of outpatient care received, demographics, and repeat ED visit within 30 and 60 days. Results were analyzed via logistic regression. Patients caregivers also were interviewed 4 weeks after the ED visit to explore barriers and facilitators to accessing outpatient care. Thematic content analysis was then performed. Results: The navigator successfully reached 533 out of 720 (74%) patients. Most patients were unable to obtain follow-up mental and behavioral health care. Univariate regression analyses revealed that being White, having commercial insurance, or a positive suicide screen had higher odds of receiving intensive outpatient care. However, these variables were not statistically significant after multivariate analyses. Barriers to follow-up included long wait times and expense. Facilitators included support from ED staff and close relationships with primary care clinicians. Conclusions: We found potential socioeconomic disparities that influence mental health care follow-up. Our findings highlight challenges patients face to receiving outpatient care, serving as a valuable guide for improving the transition from the ED to outpatient settings.

Credit & MOC Details

Credit information is provided by the course provider. We recommend confirming credit eligibility with the provider or your licensing board before starting the activity.

Credit types

This is a journal-based activity. Credit is earned after completing the required reading and assessment; the amount shown is the provider-reported available credit.

AAPA Category 1 Credit™Up to 0.75 creditsAMA PRA Category 1 Credit™Up to 0.75 creditsNursingUp to 0.75 credits

MOC types

No MOC

FDA REMS

No

Qualifies for MIPS

No

Pricing

Free

Reported to ACCME · seen on ce.icep.wisc.edu

  • Journal-based
  • Credit · Up to 0.75 credits
  • Released
    Oct 28, 2025
  • Last day to claim credit
    Oct 28, 2026 3 weeks left