As the coronavirus pandemic continues into its second year, a growing number of American families have been so desperate to get help for depressed or suicidal children that they have rushed them to emergency rooms.
A large-scale analysis of private insurance claims shows that this increase in acute mental health crises has been largely driven by one group – girls between the ages of 13 and 17.
During the second year of the pandemic, there was a 22 percent increase in the number of teenage girls who visited emergency rooms for a mental health emergency compared to a pre-pandemic baseline, with a rise in patients with suicidal behavior and eating disorders, according to the Study of 4.1 million patients Published Wednesday in JAMA Psychiatry.
During the same period, from March 2021 to March 2022, records showed a 9 percent decrease in teenage boys who had emergency room visits due to mental health issues.
Overall, the percentage of young adults who visited the emergency room for mental health issues increased by 7 percent compared to pre-pandemic baseline. The study was based on privately insured Americans, and it didn’t capture what was happening in Medicaid or uninsured households.
Although the study did not seek to explain the large gap between teenage boys and girls, the authors point to school disruption, separation from peers, and conflict at home as stressors that may affect girls in particular.
“I was particularly concerned that it was being driven by suicidal thoughts, suicidal behavior, and self-harm,” said Lindsey Overhag, study author and doctoral candidate in the Department of Health Care Policy at Harvard Medical School.
No single explanation has emerged for the gender gap in hospitalization for mental health emergencies, a trend that predates the pandemic.
Research published in 2022 by the Centers for Disease Control and Prevention found that adolescents were severely affected by parental job loss and food insecurity, with More than half of the teens Reporting emotional abuse by a parent and more than one in 10 reporting physical abuse. Two-thirds of the students said they had difficulty completing homework.
Data from Britain found it These difficulties were more pronounced for older girls from poor familieswhile narrowing the gap in the wealthiest families.
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“Girls’ peers might suggest, maybe you should talk to your parents about what’s going on, or maybe you should go and get some help,” Dr. Crawford said. Social media platforms became an important factor during the pandemic, she said, when teens were “doing TikTok searches about mental health and mental health systems.”
The JAMA Study of Insurance Claims found that emergency room visits — which were not a good way to provide acute mental health care — were particularly problematic during the pandemic, because patients often waited for long periods before inpatient psychiatric beds became available.
The study found that the second year of the pandemic led to a 76 percent increase in the number of young adults who spent two or more nights in the emergency room before admission.
Long waits, known as boarding, increase stress levels in young people in crisis, the study said, and their parents often likened the environment to a prison.
Hayden Hoskamp, an economist in the Department of Health Care Policy at Harvard Medical School and one of the study’s authors, called the increase “very dramatic” and especially troubling, given that emergency rooms provide so little care for acute mental health crises.
She said staffing shortages were likely a pivotal factor in the sharp rise in boarding. She said financial incentives – particularly reimbursement rates for mental health care – must be adjusted to allow more care for adolescents.
“Certainly having the Surgeon General come out and say this is the defining public health crisis of our time draws attention,” she said. “But changing policy takes time, and we need to move faster.”