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Kids With Autism Common Users of ERs, Study Says

Kids With Autism Common Users of ERs, Study Says

Findings suggest need for better outpatient psychiatric care

FRIDAY, Dec. 7, 2012 (HealthDay News) -- Children with autism are nine times more likely than other children to be taken to the emergency department for mental health problems, according to a new study.

The issues include aggression; mood, anxiety and psychotic disorders; attempted suicide; and self-injury.

The study also found that families with private insurance are 58 percent more likely to take children with autism to the emergency department for urgent mental health care, compared to families covered by state medical-assistance programs.

Researchers analyzed data on nearly 4 million emergency department visits made by U.S. children aged 3 to 17 in 2008. Of those visits, more than 13,000 involved children with an autism spectrum disorder. Thirteen percent of the visits by kids with autism were psychiatric in nature, compared to 2 percent of all visits made by their peers.

"This finding of higher rates of emergency room visits among children with autism demonstrates that many children with autism aren't receiving sufficient outpatient mental health care to prevent and manage the type of crises that are driving these families to seek urgent help," senior study author Dr. Roma Vasa, a child psychiatrist at the Kennedy Krieger Institute's Center for Autism and Related Disorders, said in an institute news release.

"These findings should highlight the urgent need for better comprehensive outpatient mental health care and insurance coverage for children with autism, along with greater education and training for emergency medical staff," Vasa added.

The reason families with private insurance are more likely to take children with autism to the emergency department for urgent mental health care is likely "because private insurance plans often exclude autism from behavioral health coverage, have few in-network providers or place restrictive limits on the amount of mental health expenses that they will reimburse," study first author Luther Kalb, a research scientist in the Center for Autism and Related Disorders, said in the news release.

The study was published recently in the journal Pediatric Emergency Care.

About one in 88 children in the United States has an autism diagnosis, and the use of the emergency department to treat mental health problems in these children is likely to increase unless changes occur, the researchers said.

They noted that the often chaotic nature of emergency departments can worsen mental health issues in children with autism.

"Children with autism, especially those with co-occurring psychotic disorders or severe behaviors, need to have an emergency crisis plan in place," Kalb said. "Everyone involved in the life of a child with autism, from parents to medical professionals to school educators, needs to have routine discussions about what to do in the case of an escalating situation."

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about autism (http://www.ninds.nih.gov/disorders/autism/detail_autism.htm ).

SOURCE: Kennedy Krieger Institute, news release, Dec. 3, 2012