Acad Pediatr. 2026 Apr 6:103316. doi: 10.1016/j.acap.2026.103316. Online ahead of print.
ABSTRACT
BACKGROUND: More 2- to 14-year-olds are seeking crisis mental health care in emergency departments (EDs) than ever before, yet research has predominantly focused on older adolescents.
OBJECTIVES: Synthesize existing literature on children 2 to 14 years who sought mental health care in EDs in the United States, and examined their ED diagnoses, dispositions, and trends over time.
DATA SOURCES: CINAHL, PubMed, PsycINFO, Web of Science STUDY ELIGIBILITY CRITERIA: Conducted in the US; reported ED diagnoses, dispositions, or trends over time for youth 2.0 to 14.0 years presenting for mental health complaints.
STUDY APPRAISAL AND SYNTHESIS METHODS: We followed the Joanna Briggs Institute and PRISMA-ScR guidelines and synthesized results within tables.
RESULTS: Forty-three studies, published between 1967 and 2025, met inclusion criteria. Fifteen focused exclusively on children aged 2.0 to 14.0 years; the rest stratified findings by widely varying age groups. Over half of the studies focused on suicidality-related diagnoses, and over 70% were published since 2009. Studies show young children and early adolescents presenting to EDs with increasing volume and frequency. While most children were discharged home, admissions rose among those presenting with suicide-related thoughts and behaviors.
LIMITATIONS: Variation in age group stratifications impeded some further analyses. Diagnoses assigned in EDs may be inconsistent and provider dependent.
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: This review emphasizes the need for focused attention to this growing subpopulation seeking crisis care in EDs as a distinct entity separate from adolescents, while also encouraging innovative methods for equitable early identification and treatment.
SCOPING REVIEW REGISTRATION NUMBER: DOI 10.17605/OSF.IO/7UMC5.
PMID:41951037 | DOI:10.1016/j.acap.2026.103316
