Abstract Background The prevalence of mental and behavioral health (MBH) conditions in children has been increasing in the past two decades.
Abstract Background The prevalence of mental and behavioral health (MBH) conditions in children has been increasing in the past two decades. Emergency departments (EDs) are also experiencing a significant rise in MBH-related visits, leading to challenges in providing care. Gaining insight into the underlying characteristics of pediatric patients at higher risk of MBH conditions is crucial for understanding this population in the ED and addressing their complex care needs. This study aims to examine the characteristics of children reported to be at risk and not at risk of MBH conditions to identify the population characteristics associated with ED visits. The objective was to analyze data from the 2019 National Health Interview Survey (NHIS) to evaluate the odds of ED visits among children and to identify patterns among those at higher risk of MBH conditions. Methods The study utilized data from the 2019 NHIS Sample Child Survey, focusing on children aged 6–17. Following established guidelines, children with a Strengths and Difficulties Questionnaire total score of 16 or higher were classified as having higher risk of MBH conditions. Binary logistic regression and ordinal logistic regression analyses were conducted in R. Three models were created; the first two examined factors among the general pediatric population associated with one ED visit or multiple ED visits within a year. The last model examined only children at higher risk of MBH conditions and the factors associated with ED visits in this sub-population. Results The weighted sample size of the survey consisted of 49,330,998 children. Approximately 15.8% of children had been to the ED at least once in the past year and 6.6% of children were at risk of MBH conditions. The regression analyses revealed children reported at higher risk of MBH conditions were significantly more likely to visit the ED. Other factors associated with ED visits included preexisting health conditions such as asthma, suboptimal health status, and financial strain. Among children at higher risk of MBH conditions, having a consistent primary care setting (e.g., doctor’s office or health center) was associated with significantly lower odds of visiting the ED. Conclusions The study provides insights into the characteristics of children with and without risk of MBH conditions, as well as their associated odds of ED visits. Understanding these factors can contribute to interventions and improvements within the ED for children presenting for MBH-related conditions. Further research is needed to improve care for this patient population in the ED.
