ED STOP and PMHCA: Updates from two initiatives on pediatric mental health

September was National Suicide Awareness Month. Based on the most recent statistics for the United States, suicide is the second leading cause of death for children, adolescents, and young adults, ages 10-24 years.

Emergency department (ED) utilization for pediatric mental health visits increased by 8% annually between 2015 and 2020. All other visits increased by 1.5% annually.

The EMSC Innovation and Improvement Center (EIIC) is working to prevent suicide and self-harm risk among youth and adolescents. Below are updates on two initiatives working to improve behavioral health and mental health outcomes for children: the ED Screening and Treatment Options for Pediatric (STOP) Suicide Quality Improvement (QI) Collaborative or ED STOP Suicide QI Collaborative and the Pediatric Mental Health Access Program (PMHCA).

ED STOP Suicide QI Collaborative

To help improve clinical care processes for children in crisis presenting to EDs, the ED STOP Suicide QI Collaborative was launched in 2023. The collaborative will wrap-up this November.

The collaborative includes 78 ED-based teams consisting of 324 participants in 30 states, plus the District of Columbia. The collaborative also includes 27 EMSC State Partnership Program managers and 17 Pediatric Mental Health Care Access (PMHCA) representatives. Currently, the teams are focused on identifying and implementing one or more strategies in their site's ED to improve clinical care processes for children with suicidal ideation. The implementation strategies relate to the four clinical focus areas: suicide ccreening, mental health assessment, ED-based interventions, and discharge and safety planning. ED site QI projects range from implementing universal screening, to creating parent intake forms in multiple languages, to creating a sensory cart for pediatric patients who have sensory needs, attention deficit/hyperactivity disorder, or autism spectrum disorder in the ED, and more!

While the collaborative ends in November, many participating teams are moving into the Pediatric Readiness Quality Collaborative (PRQC), which includes suicide as a high-priority focus area.

PMHCA

EIIC has partnered with PMHCA, a program of the Health Resources and Services Administration, in seven different states. The goal is to bridge the gaps in services and create partnerships to connect EDs and primary care providers to the resources PMHCA programs can provide.

The seven PMHCA teams have participated in EIIC’s ED STOP Suicide QI Collaborative to connect with EDs and learn more about their clinical pathways to care for pediatric patients presenting behavioral or mental health concerns in the ED. Currently, the project team is recruiting new teams for year two of the grant and is continuing to work with current teams to complete a technical assistance toolkit.

If you or a loved one are experiencing suicidal thoughts, please call the National Suicide Prevention Lifeline at 988 or text the Crisis Text Line at 741741. Help is free, available 24/7, and confidential.