History of Out-of-Home Placement Linked to Prolonged Emergency Department Stays and Increased Restraint Use in Youth Mental Health Crises

Introduction

The landscape of pediatric mental health has shifted dramatically over the last decade. Emergency departments (EDs) across the United States have become the de facto front line for children and adolescents experiencing acute psychiatric crises. While the rise in ED utilization for mental health concerns is well-documented, the disparities in care delivery and outcomes within this setting remain a subject of intense investigation. One particularly vulnerable population often overlooked in clinical research is youth with a history of out-of-home placement (OOHP), including those in foster care, group homes, or kinship care. A recent study published in JAMA Network Open provides a critical look at how these histories impact the trajectory of care in the ED, specifically regarding length of stay (LOS) and the use of physical and pharmacological restraints.

Highlights