Mental Health Service Use Before and After a Suicidal Crisis Among Children and Adolescents in a United States National Medicaid Sample.
adolescents
emergency care
mental health
suicide
Journal
Academic pediatrics
ISSN: 1876-2867
Titre abrégé: Acad Pediatr
Pays: United States
ID NLM: 101499145
Informations de publication
Date de publication:
Historique:
received:
22
12
2020
revised:
21
04
2021
accepted:
25
04
2021
pubmed:
1
6
2021
medline:
18
9
2021
entrez:
31
5
2021
Statut:
ppublish
Résumé
Mental health follow-up after an emergency department (ED) visit for suicide ideation/attempt is a critical component of suicide prevention for young people. We analyzed 2009 to 2012 Medicaid Analytic EXtract for 62,139 treat-and-release ED visits and 30,312 ED-to-hospital admissions for suicide ideation/attempt among patients ages 6 to 17 years. We used mixed-effects logistic regression models to examine associations between patients' health care utilization prior to the ED visit and likelihood of completing a 30-day mental health follow-up visit. Overall, for treat-and-release ED visits, 49% had a 30-day follow-up mental health visit, and for ED-to-hospital admissions, 67% had a 30-day follow-up mental health visit. Having a mental health visit in the 30 days preceding the ED visit was the strongest predictor of completing a mental health follow-up visit (ED treat-and-release: adjusted odds ratio [AOR] 11.01; 95% confidence interval [CI] 9.82-12.35; ED-to-hospital AOR 4.60; 95% CI 3.16-6.68). Among those with no mental health visit in the 30 days preceding the ED visit, only 25% had an ambulatory mental health follow-up visit. Having a general health care visit in the 30 days preceding the ED visit had a much smaller association with completing a mental health follow-up visit (ED treat-and-release: AOR 1.17; 95% CI 1.09-1.24; ED-to-hospital AOR 1.25; 95% CI 1.17-1.34). Young people without an existing source of ambulatory mental health care have low rates of mental health follow-up after an ED visit for suicide ideation or attempt, and opportunities exist to improve mental health follow-up for youth with recent general health care visits.
Identifiants
pubmed: 34058404
pii: S1876-2859(21)00246-1
doi: 10.1016/j.acap.2021.04.026
pmc: PMC8429213
mid: NIHMS1721584
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1171-1178Subventions
Organisme : NIMH NIH HHS
ID : K23 MH115162
Pays : United States
Organisme : NIMH NIH HHS
ID : R01 MH107452
Pays : United States
Informations de copyright
Copyright © 2021 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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