Evidence map›Paper›PMID 40011808›Full record

ArticleBMC primary care2025

Trends in Emergency Department, Primary Care, and Behavioral Health Use for Pediatric Mental Health Conditions in Virginia before and during the COVID-19 pandemic.

Jennifer L Gilbert, Bergen B Nelson, Jacqueline Britz, Benjamin Webel, Evan French, Jong Hyung Lee, Elizabeth R Wolf, E Marshall Brooks, Roy T Sabo, Ally Singer Wright and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Jennifer L GilbertDepartment of Family Medicine and Population Health, Virginia Commonwealth University, 830 E Main Street, Richmond, VA, 23298, USA. jennifer.gilbert2@vcuhealth.org.
Bergen B NelsonDepartment of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA.
Jacqueline BritzDepartment of Family Medicine and Population Health, Virginia Commonwealth University, 830 E Main Street, Richmond, VA, 23298, USA.
Benjamin WebelDepartment of Family Medicine and Population Health, Virginia Commonwealth University, 830 E Main Street, Richmond, VA, 23298, USA.
Evan FrenchWright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA.
Jong Hyung LeeDepartment of Family Medicine and Population Health, Virginia Commonwealth University, 830 E Main Street, Richmond, VA, 23298, USA.
Elizabeth R WolfDepartment of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA.
E Marshall BrooksDepartment of Family Medicine and Population Health, Virginia Commonwealth University, 830 E Main Street, Richmond, VA, 23298, USA.
Roy T SaboDepartment of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.
Ally Singer WrightVirginia Mental Health Access Program, Fairfax, VA, USA.
Rachel ReynoldsVirginia Mental Health Access Program, Fairfax, VA, USA.
Kyle WendlingVirginia Mental Health Access Program, Fairfax, VA, USA.
Scott M StrayerDepartment of Family Medicine and Population Health, Virginia Commonwealth University, 830 E Main Street, Richmond, VA, 23298, USA.
Sandy L ChungVirginia Mental Health Access Program, Fairfax, VA, USA.
Alex H KristDepartment of Family Medicine and Population Health, Virginia Commonwealth University, 830 E Main Street, Richmond, VA, 23298, USA.

Funding

Wright Regional Center for Clinical and Translational ScienceUM1TR004360 · NCATS · VIRGINIA COMMONWEALTH UNIVERSITY · PI FREDERICK Gerard MOELLER · 2023 to 2026
$16.3M
Virginia Accountable Health Equity and Action Dashboard (VA-AHEAD): Community Framing of Equity Data to Support Clinical and Translational ScienceRC2TR005115 · NCATS · VIRGINIA COMMONWEALTH UNIVERSITY · PI Alexander H Krist · 2024 to 2026
$3.7M
NCATS NIH HHS RC2 TR005115NCATS NIH HHS UM1 TR004360
6 · The paper itself

Abstract

backgroundPediatric emergency department (ED) visits for mental health are costly and often preventable. Access to primary care and behavioral health providers can improve mental health and reduce unnecessary ED visits.

methodsQuantitative analysis of the Virginia All-Payers Claims Database to assess mental health ED and outpatient care for children and adolescents up to age 21 years between 2016 and 2021. We determined the proportion of children and adolescents seen by primary care or behavioral health one week and one year before an ED visit, and how many had follow-up care within one and two months after.

resultsFrom 2016 to 2021, pediatric ED visits dropped 14%, but mental health visits rose 10.6%, and suicidality visits tripled (301 to 929, p < 0.001). Only 5% of youth with suicidality ED visits had a primary care visit within 7 days prior, and 18% saw a mental health provider. During the pandemic, prior-year primary care visits for mental health ED cases declined (68.1-61.8%, p < 0.0001). Follow-ups within 60 days dropped for primary care (mental health: 40.0-34.2%; suicidality: 37.5-33.5%), slightly improved for behavioral health (32.2-37.1%), and stayed stable for suicidality (64.1-63.0%).

conclusionsThe pediatric mental health crisis has worsened since the pandemic. There were substantial missed opportunities for prevention and intervention for children and adolescents prior to and following an ED visit for mental health or suicidality.

Indexed as

COVID-19Emergency Service, HospitalMental DisordersMental Health ServicesPrimary Health CareAdolescentChildChild, PreschoolFemaleHumansInfantMaleSARS-CoV-2VirginiaYoung AdultBehavioral healthCOVID-19 pandemicEmergency department utilizationPediatric mental healthPrimary careSuicidality

Identifiers

PMID40011808
PMCPMC11863954

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.