Friday, October 28, 2022

Study Highlights Children Most Likely to Be Taken to Psychiatric ER By Police After 911 Call

Compared with children taken to a psychiatric emergency room (ER) by family, those taken by police after a 911 call were more likely to be male, older, and Black, a report in Psychiatric Services has found.

“Clinical and sociodemographic differences in police arrivals highlight the need for a comprehensive systems approach for children, especially marginalized youths, who need psychiatric emergency care,” wrote Wilfred Farquharson IV, Ph.D., of Stony Brook University and colleagues.

The findings were based on data contained in the electronic medical records of children between the ages of 5 and 12.9 years who were brought to a psychiatric ER at a suburban university hospital between September 2017 and April 2018. Farquharson and colleagues specifically focused their analysis on such information as the children’s age, sex, and race/ethnicity; insurance status; living situation (for example, living with two parents versus not); referral source; occurrences of aggression and suicidality; and number of psychiatric ER visits.

The researchers compared children who were taken to the psychiatric ER by the police with those children taken to the psychiatric ER by their family. They noted, “The police brought children to the CPEP [comprehensive psychiatric emergency program] when someone [for example, caregiver or school personnel] called 911 and the responding officers felt that evaluation in the CPEP was warranted.”

During the study period, 339 children under age 13 were seen in the psychiatric ER a total of 435 times. Of these children, 30% were taken to the psychiatric ER by the police at least once through March 2020 (the end of the follow-up period); 7% were taken by the police multiple times; and 13% were taken multiple times by a combination of the police and family. Of the children taken to the psychiatric ER by family only, 70% had a single psychiatric ER visit, and 30% had multiple visits.

Although Black children and Latinx children were significantly more likely to be taken to the psychiatric ER by police compared with White and Asian or other children, Farquharson and colleagues reported that “only Black race, older age, male gender, not living in a two-parent family, and having Medicaid insurance were independently associated with a first police arrival.” They added, “Black children were brought to the ER for outbursts or aggression more often than their peers, whereas Asian or other children were more often brought for suicidality.”

The authors highlighted several limitations of the study, including that data were from one suburban, university-based psychiatric ER.

They concluded, “Our data are consistent with reports of serious behavioral health crises among children and adolescents that are often not adequately addressed by ERs, inpatient units, and outpatient treatment. These crises thus lead to law enforcement referrals that are used disproportionately for individuals who are marginalized and publicly insured.”

For related information, see the Psychiatric News article “Negative Language in Medical Records More Common for Black Patients” and the Psychiatric News AlertBlack Children Less Likely to Report Suicidal Thoughts in Emergency Room, Study Suggests.”

(Image: iStock/MJFelt)

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