Mental Health and COVID-19 in Pediatric Emergency Departments: Perspectives From Directors

PURPOSE: The aim of this study is to understand pediatric emergency department (PED) directors’ perspectives on the COVID-19 pandemic’s effect on PED visits for mental health concerns. METHODS: Semi-structured phone interviews were conducted with a national convenience sample of PED directors. Interviews were recorded, transcribed verbatim, and analyzed using rapid content analysis. RESULTS: Twenty-one PED directors from 18 states were interviewed. Directors perceived an increased volume of mental health visits and higher patient acuity. Some PEDs innovatively adapted services but were also met with new barriers in providing care due to increased use of personal protective equipment and required COVID-19 testing. Transfer to inpatient psychiatric units was more complicated due to reduced overall bed capacity and the need for a negative COVID test. DISCUSSION: The COVID-19 pandemic strained an already fragile pediatric emergency mental health system. Building infrastructure for adaptations and mental health service reserve capacity could help ensure proper care for pediatric patients with mental health crises during future public health emergencies.