• Posted June 4, 2025

Troubled Kids Wait a Half-Day — Or More — In ER To Get Mental Health Care

Troubled children and teenagers are languishing hours in chaotic hospital emergency rooms, waiting for a psychiatric bed to open, a new study says.

About 1 in 3 kids who go to an emergency room (ER) amid a mental health crisis wait at least 12 hours to be transferred to psychiatric care, researchers report in the August 2025 issue of the Journal of the American College of Emergency Physicians Open.

Further, more than 1 in 8 wait more than 24 hours before they are sent on to treatment, researchers found.

“Our study underscores significant issues with access to mental health care for children and adolescents, who often face prolonged ED [emergency department] stays because a psychiatric bed is not available,” lead researcher Dr. Jennifer Hoffmann, behavioral health medical director for emergency medicine at Ann & Robert H. Lurie Children’s Hospital of Chicago, said in a news release.

“As the youth mental health crisis continues, we have been seeing more severe psychiatric conditions in the ED,” she said. “Most of these kids seek emergency care at adult hospitals, which often have more limited pediatric resources compared to children’s hospitals and might not be prepared to provide the necessary supports.”

For the new study, researchers analyzed records representing more than 5.9 million mental health ER visits for kids aged 5 to 17, using federal survey data collected between 2018 and 2022.

About 1% of these visits occurred at a children’s hospital ER, researchers said.

Of all those trips to the ER, about 25% resulted in a child being admitted or transferred for further psychiatric care, researchers said.

Results show that 32% of those kids wait at least 12 hours for a bed to open up.

These kids are often aggressive and suicidal, researchers found. In all, 7 in 10 who wait more than 12 hours are at the ER for suicidal thoughts or attempts, and more than half for aggressive behavior.

Children covered by private insurance were 69% less likely to wait in the ER than those covered by Medicaid or CHIP, researchers found.

“Differences in reimbursement rates for psychiatric services, which are often lower with public relative to private insurance, may contribute to inequities in care access,” Hoffmann said.

Children ages 5 to 9 were nearly 10 times more likely to stay in an ER for more than 24 hours, compared to 15- to 17-year-olds, results show.

Likewise, Black children were 15 times more likely to have an ER stay of more than 24 hours compared to white kids.

The results show that general hospitals need to streamline the process of getting troubled children to the care they need, researchers said.

For example, more than 70% of the children underwent blood tests, even though nearly none of these tests matter when it comes to their psychiatric care, researchers said. 

“Obtaining such testing can both prolong ED stay and increase costs of care,” researchers wrote, noting that the American Academy of Pediatrics recommends against screening lab testing before a psychiatric admission.

More information

The American Psychological Association has more on the mental health crisis among children.

SOURCES: Ann and Robert H. Lurie Children's Hospital of Chicago, news release, May 28, 2025; Journal of the American College of Emergency Physicians Open, August 2025