Current and Desired Behavioral Health Resources for Children: A Survey of Illinois Emergency Departments.

Abstract

Objectives: In the context of rising emergency department (ED) visits by children for behavioral health (BH) concerns, our objective was to understand current and desired resources for the care of children presenting to Illinois EDs with BH concerns.

Methods: We surveyed nurse pediatric emergency care coordinators (PECCs) and nurse managers working in Illinois EDs participating in the Pediatric Facility Recognition Program from March 15 to June 30, 2025. We assessed ED characteristics, pediatric BH care practices, and current and desired BH resources.

Results: Among 101 eligible EDs, 65 (64%) responded. Respondents included nurse PECCs (77%), nurse managers (17%), and nurses serving in both roles (6%). Most EDs (60%) were in hospitals without a pediatric inpatient unit, 22% were in critical access hospitals, and 67% had <4999 annual pediatric ED visits. On-site mental health professionals and telemental health services were available in 56% and 44% of EDs, respectively. Universal suicide risk screening was reported in 88% of EDs, most frequently using the Columbia-Suicide Severity Rating Scale Screen Version (87%) and starting at age 8 (36%). Among EDs, 56% reported always or often providing all elements of safety planning. Frequently desired resources included activity kits (82%) and a portal to view pediatric psychiatric inpatient bed availability (73%). High priority resources included a mechanism to escalate difficult cases (23%) and increased access to mental health professionals in the ED (23%).

Conclusion: Survey findings inform opportunities to standardize and improve pediatric BH emergency care through the development and dissemination of desired resources.