A new study from the Centers for Disease Control and Prevention (CDC) highlights a sobering reality: over one million emergency room (ER) visits each year involve children and adolescents diagnosed with a mental health disorder. These Youth Mental Health ER Visits, based on nationally representative data, reveal a growing mental health crisis among America’s youth—one that is straining already overwhelmed emergency departments to serve as the first line of defense for psychiatric care.
While the numbers alone are startling, the story behind them is even more concerning. The study, conducted in collaboration with the National Center for Health Statistics, shows not only a steep increase in the number of Youth Mental Health ER Visits but also highlights systemic issues—such as lack of access to outpatient mental health care, closure of psychiatric facilities, and socioeconomic and racial disparities—that continue to hinder early intervention and long-term solutions.
Emergency Departments: The De Facto Mental Health Clinics
Historically, emergency departments have been places of last resort—intended for acute crises like heart attacks, injuries, or severe illnesses. But as access to pediatric and adolescent mental health services continues to shrink, many families have no choice but to turn to the ER when their child is in psychological distress.
The CDC’s data reveals that between 2015 and 2020, Youth Mental Health ER Visits increased by an average of 8% per year, while ER visits for all other reasons rose by just 1.5% annually. Notably, this trend held steady even in 2020, despite the unique circumstances of the COVID-19 pandemic, suggesting a deeply rooted and ongoing problem rather than a short-term spike.
According to the study’s authors, this uptick in Youth Mental Health ER Visits reflects “decreased availability of psychiatric facilities and challenges in accessing outpatient services.” As a result, emergency departments are being used as a stopgap, often lacking the specialized resources, time, and environment needed for effective mental health treatment.
Who Is Most Affected? A Closer Look at Demographics
The study also provides a detailed breakdown of which groups are most impacted by this trend—and the findings raise critical equity questions.
Adolescents are more likely to visit the ER for mental health concerns than younger children. This likely reflects the age at which common conditions like depression and anxiety first appear. It may also indicate that early signs of disorders such as ADHD or behavioral challenges are being missed or dismissed during childhood, only coming to clinical attention when symptoms escalate during adolescence.
Girls were found to make more Youth Mental Health ER Visits than boys—16.1 visits per 1,000 children, compared to 12.1 for boys. Interestingly, this gender difference does not exist in ER visits unrelated to mental health, suggesting that girls may be experiencing or reporting higher rates of psychiatric distress.
Racial disparities were also prominent. Black, non-Hispanic children had the highest rate of Youth Mental Health ER Visits at 20.8 per 1,000, followed by white children at 14.4 and Hispanic children at 13.2. These gaps mirror broader health inequities and point to systemic barriers, including access to culturally competent care, early intervention services, and supportive community resources.
The Toll on Patients and the Healthcare System
The consequences of these ER visits extend far beyond the initial moment of crisis.
For children and adolescents visiting the ER with mental health concerns:
- 9.2% were hospitalized following their visit, nearly twice the rate for non-mental health cases (4.7%).
- 12.4% were transferred to psychiatric hospitals, compared to only 0.3% of those without a mental health diagnosis.
- 42% of visits lasted four hours or more, versus 17.8% for non-psychiatric visits, highlighting how long families often wait for appropriate psychiatric placement or evaluation.
These prolonged and intensive encounters not only strain hospital resources but also place immense stress on families and young patients, many of whom leave without a clear path to follow-up care or a long-term support plan.
Common Diagnoses Driving the Spike
The study also shed light on which conditions are most commonly diagnosed during these visits:
- Mood disorders, such as depression and bipolar disorder, were the most frequent at 5 ER visits per 1,000 children and adolescents.
- Anxiety disorders followed closely at 4.4 per 1,000.
- Behavioral and emotional disorders were diagnosed at a rate of 3.7 per 1,000.
- Substance use disorders and developmental disorders (such as autism spectrum disorder) were also notable, at 1.8 and 1.7 visits per 1,000 respectively.
This diagnostic data further reinforces the need for early identification, school-based screenings, and increased access to outpatient mental health care to prevent conditions from escalating to crisis levels.
Experts Call for Systemic Change
Mental health professionals and industry leaders are sounding the alarm and calling for comprehensive reform. Rola Aamar, principal of behavioral health solutions at Relias, described the findings as both troubling and expected.
“This trend continues to be a concern, but it is not a surprise,” Aamar told Behavioral Health Business. “Healthcare providers and researchers have been focused on the increasing numbers of emergency department and hospital visits for several years now, specifically calling for increased access to services and addressing gaps in access to care.”
According to Aamar and other experts, turning the tide will require large-scale transformation across several fronts:
- Expanded access to youth mental health services, particularly in schools and communities
- Improved reimbursement models to ensure mental health care is adequately funded
- Stigma reduction campaigns to encourage families to seek help earlier
- Integrated care models that link physical and mental health treatment in pediatric and primary care settings
These interventions must be proactive rather than reactive, aiming to build a mental health infrastructure that identifies and treats issues before they escalate to an emergency.
A System at a Breaking Point
The surge in Youth Mental Health ER Visits is not merely a reflection of individual distress—it is a reflection of a fragmented, overburdened, and under-resourced mental health system. As emergency rooms become overwhelmed with cases they were never designed to handle, children and families are left in limbo—waiting hours or days for help that may never come.
If this trajectory continues unchecked, the long-term consequences for the next generation’s health, development, and well-being could be devastating. The time for incremental change has passed. Bold, coordinated action is required to ensure that every child has access to timely, compassionate, and effective mental health care—before their only option is an emergency room visit.
