Suicide-related emergency department visits in US children rose 74% from 2016 to 2022

Emergency department (ED) visits by US children for suicide-related concerns rose 74% from 2016 to 2022, and about half occurred at hospitals with lower pediatric volume, according to a national analysis published in Annals of Emergency Medicine.¹

“A child experiencing a mental health crisis may arrive at any emergency department,” said lead author Audrey Brewer, MD, MPH, a pediatrician and researcher at Ann & Robert H. Lurie Children’s Hospital of Chicago and assistant professor of pediatrics at Northwestern University Feinberg School of Medicine.² She said the results underscore the need to equip every ED, not only large pediatric centers, with tools for evidence-based mental health care.²

Nationwide Emergency Department Sample trends in pediatric suicide-related visits

The retrospective cross-sectional study used the 2016 to 2022 Nationwide Emergency Department Sample, which covers about 20% of US EDs and is weighted to produce national estimates.¹ Investigators included children aged 5 to 17 years with a primary mental health diagnosis, for a weighted total of 5,369,821 visits.¹ Mental health–related visits rose 24%, from 668,054 in 2016 to 858,638 in 2022.¹ Suicide-related visits, defined by any diagnosis in the suicide or self-injury group, rose from 224,850 to 391,491, and the increase appeared in every pediatric volume category.¹ Suicide or self-injury (24.1%) and depressive disorders (23.2%) were the most common primary diagnosis groups.¹

Lower-volume EDs and pediatric mental health care capacity

High-volume EDs, defined as 10,000 or more pediatric visits annually, saw 50.1% of mental health visits and 49.2% of suicide-related visits.¹ The authors noted that lower-volume EDs often have fewer pediatric-specific resources, such as onsite pediatric mental health professionals, and may not offer universal suicide risk screening or safety planning.¹

Transfers rose as volume fell. At the lowest-volume EDs, close to 30% of children seen for mental health conditions were transferred to another hospital.² Senior author Jennifer Hoffmann, MD, MS, a pediatric emergency medicine physician at Lurie Children’s, said transfer often means a prolonged ED wait, sometimes lasting days.²

Racial, ethnic and diagnostic differences in ED site of care

After adjustment, Black (adjusted odds ratio [aOR], 1.19; 95% CI, 1.05-1.35) and Hispanic (aOR, 1.69; 95% CI, 1.44-1.98) children had higher odds than non-Hispanic White children of presenting to a high-volume ED.¹ Native American children had lower odds (aOR, 0.54; 95% CI, 0.35-0.83).¹ Children with substance-related diagnoses were also less likely than those with suicide or self-injury to be seen at high-volume EDs (aOR, 0.79; 95% CI, 0.71-0.87).¹ Race and ethnicity data were available only for 2019 to 2022.¹

Youth mental health ED visit trends in context

The findings extend earlier national data. A JAMA analysis found youth mental health–related ED visits rose from 4.8 million to 7.5 million between 2011 and 2020, with suicide-related visits showing the greatest increase.³

Limitations and next steps for pediatric ED suicide prevention

The authors described the work as exploratory and called for replication in additional data sources.¹ Because the database lacks patient-level identifiers, the 74% figure reflects visits rather than unique children, and diagnosis codes may misclassify diagnoses and severity.¹ The study also could not assess adverse childhood experiences or neighborhood-level drivers of ED use.¹ As a cross-sectional analysis, it cannot explain why visits rose.

Hoffmann pointed EDs to the New England Regional Behavioral Health Toolkit and the National Pediatric Readiness Project.² The paper also cites a federal toolkit for pediatric mental health care in the ED and suggests strengthening community-based services, including primary care and school integration, to reduce ED reliance.¹ Brewer said ED-based interventions need to be developed and tested in children of color, since many have not been studied in diverse populations.²

References

1. Brewer AG, Michelson KA, Masias E, Walter T, Robinson K, Hoffmann JA. Childhood mental health-related visits and emergency department pediatric volume in the United States, 2016 to 2022. Ann Emerg Med. Published online September 3, 2026. doi:10.1016/j.annemergmed.2026.07.015

2. Children’s suicide-related emergency visits spiked by 74% in U.S. News release. Ann & Robert H. Lurie Children’s Hospital of Chicago. September 4, 2026. Accessed September 21, 2026. https://www.newswise.com/articles/children-s-suicide-related-emergency-visits-spiked-by-74-in-u-s

3. Bommersbach TJ, McKean AJ, Olfson M, Rhee TG. National trends in mental health-related emergency department visits among youth, 2011-2020. JAMA. 2023;329(17):1469-1477. doi:10.1001/jama.2023.4809