Children in Mental-Health Crisis Surge Into Hospital E.R.s

Rising cases and long waits for treatment have desperate families turning to emergency departments for help

Originally posted on WSJ.com by Dan Frosch and Melanie Evans on 11/8/2023.

Dr. Christopher Lucas shuttled from room to room, checking on the children with mental-health troubles who had streamed into his emergency department over the past 12 hours because they had nowhere else to go.

There were eight of them that September day at Upstate University Hospital in Syracuse, N.Y. In one room, staff tended to a 17-year-old girl with chronic depression who had attempted suicide by overdosing on ibuprofen—her fourth trip to the E.R. for mental-health reasons in two years. Nearby was a 14-year-old girl who had started cutting herself after being bullied over social media.

The youngest new patient was a 5-year-old boy with behavioral disorders. His mother had tried to get him into outpatient therapy, but there was a long wait list. A physician assistant at a different emergency department had prescribed him five medications in the meantime, said Lucas, the hospital’s vice chair of psychiatry. After the boy tried to stab his mom and said he wanted to kill himself, she’d brought him to the E.R. at Upstate. 

While anxiety, depression and other mental-health conditions started to climb among children before Covid, they soared during the isolation and disruption of the pandemic. The increased demand for treatment exacerbated a shortage of available mental-health services. This has left desperate families pouring into emergency departments that legally can turn no one away. 

“We’re the place of last resort to mop up after the system has failed,” said Lucas.

The influx of young mental-health patients is overcrowding emergency departments and delaying treatment across the country at both specialized children’s hospitals and general hospitals.

Major pediatric and emergency medicine organizations issued a public warning to hospitals and doctors in August, stating that the lack of space and available staff is forcing children who need psychiatric care to wait too long in E.R.s.