Some of the saddest moments I have experienced as a social worker were in pediatric emergency rooms. There are few things more horrific than a child’s death or life-threatening illness. Even watching a child struggle with more minor medical problems can be pretty wrenching. Which is why it's not so great when emergency rooms also are places where children are brought who are having serious behavioral issues. Among other potential negative consequences, time in the ER may cause secondary trauma for children and families, and expose them to experiences that might further harm them, rather than help them. The fact that evaluations in the ER frequently lead to inpatient hospital stays for children is also a problem.
There is a better way to deal with many behavioral health care issues for children, and the Children’s Fund of Connecticut recently announced a grant to support this better way. With an investment of $57,500 to the University of Connecticut’s School of Social Work, the Children’s Fund of Connecticut is supporting further research on the use of emergency departments among children with behavioral issues, and the use of community-based treatment from a mobile treatment team.
The grant will support UCONN’s School of Social Work to “evaluate the impact of Connecticut's Emergency Mobile Psychiatric Services program on the use of emergency departments among youth with behavioral health concerns.” Connecticut is a good testing ground for this research, since it has developed one of the nation’s strongest mobile crisis intervention programs for children.
The Children’s Fund of Connecticut provided over $1.4 million in grants to community organizations in 2015, with the bulk of their funding (over $1 million) going to the Child Health and Development Institute, which is charged with advancing best practices and “sustainable improvements in primary and preventive health and mental health care in Connecticut.” The remainder of the fund’s grants for 2015 went to a range of organizations addressing children’s issues including anti-obesity campaigns, early childhood care, and mental health.
The research team studying ED use for behavioral health at UCONN is led by Michael Fendrich, Ph.D. and will compare clients who use the mobile treatment services with clients who use emergency rooms. The goal is to help identify risk factors for emergency room services, and best practices for routing more children and families to the most appropriate setting for care.
For most children, mobile community-based services are a better alternative. Schools and families can reach out to this treatment team, rather than going to a pediatric emergency room, and often resolve issues by creating a specific safety plan. Also a bonus: mobile treatment teams are almost always dramatically less costly than treatment in an emergency room.
This is not the first of these types of services to be provided or studied, but as a practitioner in the field, I can verify that there are not enough of these services in many communities. I have heard stories from families who have been in the ER with their children seeking help for a behavioral crisis, and secondary trauma from their experiences can be a real issue.