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Pediatric Mental Health Crisis Tops ECRI’s List of 2023 Patient Safety Concerns

Each year, nonprofit ECRI creates a list of the industry’s top ten patient safety concerns. This year, the pediatric mental health crisis topped the list, above other important issues like violence against healthcare staff and clinicians being expected to work outside their scope of practice.

The worsening mental health crisis among children and adolescents is the most pressing issue affecting patient safety, according to ECRI.

Each year, the nonprofit creates a list of the industry’s top ten patient safety concerns. This year, the pediatric mental health crisis topped the list, above other important issues like violence against healthcare staff and clinicians being expected to work outside their scope of practice.

While it’s documented that levels of depression and anxiety among children have been increasing since before the pandemic, ECRI noted that the pandemic exacerbated the situation to a full crisis. There was a 29% increase in children ages 3 to 17 experiencing anxiety and a 27% increase in depression in 2020 compared to 2016.

This lack of pediatric mental healthcare providers is problematic because depression developed during youth is more likely to continue into adulthood if left untreated, ECRI said. However, only half of Americans ages 5 to 21 who have major depression are diagnosed. Of those who are, just 40% receive any mental health treatment.

The problem has also been escalated by healthcare’s workforce shortage, ECRI CEO Marcus Schabacker said in a recent interview.

“It is aggravated by particularly the mental healthcare workers leaving the space because they’re burnt out, they’re overworked and they’re challenged with this avalanche of new cases,” he declared.

The increasing rates of anxiety and depression among young people have led to a rise in suicidal ideation among the age group. The average weekly number of emergency department visits for suspected suicide attempts among patients ages 12 to 17 was 22% higher in summer 2020 and 39% higher during winter 2021 compared to the corresponding periods in 2019.

Schabacker pointed out that this crisis has a disproportionate effect on children who come from populations that are underprivileged or discriminated against. For example, he said that one in four LGBTQ youth have thought about completing the act of suicide, whereas this figure is only 5% among their straight peers.

This issue also hits harder among those living in poverty.

“Young people in socioeconomically disadvantaged communities have a higher likelihood of suicide not only because of all the stressors they experience — but then on top of that — they have less resources,” Schabacker explained.

ECRI gave healthcare providers a few recommendations on how to address the crisis.

The nonprofit suggested that hospitals establish a team of leaders and frontline staff to evaluate the facility’s strengths and gaps in meeting pediatric patients’ behavioral health needs, as well as to advocate for youth mental health improvement initiatives at the regional, state and national level.

Additionally, the organization recommended that providers implement universal screening for depression, anxiety, abuse, substance use and suicidal ideation for pediatric patients during every office and hospital visit. Providers should also assess patients’ social determinants of health and provide additional support to
children and caregivers who are identified as being at increased risk, ECRI suggested.

Photo: Wacharaphong, Getty Images

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