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Emergency Visits for Deliberate Self-Harm by Children Tripled in 10 Years

June 30, 2020

Pediatric emergency department visits for deliberate self-harm rose 329% from 2007 to 2016, while emergency visits for children with a substance use disorder grew 159%, according to a study published online in the journal Pediatrics.

“Over the 10-year study period, pediatric emergency department visits were stable; however, pediatric emergency department visits for all mental health disorders rose 60%,” researchers reported. “Importantly, we observed a threefold increase in emergency department visits for deliberate self-harm, similar to trends reported by authors of other studies, suggesting that children are increasingly engaging in self-harm.”

To assess recent shifts in pediatric mental health visits in emergency departments throughout the United States, researchers analyzed data from the Nationwide Emergency Department Sample for the years 2007 to 2016. 

Addressing Mental Health Needs in Children Before They Reach the ED 

In addition to a tripling of pediatric emergency department visits for deliberate self-harm, the study showed a steady rise in pediatric mental health-related emergency department visits. In the majority of cases, patients did not seek care at specialized pediatric emergency departments.

“We demonstrated significantly increased visits by children with mental health disorders to small-pediatric-volume, rural emergency departments that may be least likely to be prepared to provide higher-level pediatric care,” wrote researchers. 

The 159% increase in pediatric emergency department visits for a substance use disorder was accompanied by a 39% decrease in visits for children with alcohol-related disorders over the 10-year period. With continued escalation of the opiate epidemic, the increase in substance use disorder visits despite a decline in alcohol use disorder visits warrants attention and further investigation, researchers advised.

—Jolynn Tumolo 


Lo CB, Bridge JA, Shi J, Ludwig L, Stanley RM. Children's mental health emergency department visits: 2007-2016. Pediatrics. 2020;145(6):e20191536.

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