Medical Student The Warren Alpert Medical School of Brown University Providence, Rhode Island, United States
Background: Nearly 1 in 5 children and adolescents younger than 18 years in the United States have one or more mental health disorders, with an even higher rate in lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) youth. A recent Centers for Disease Control and Prevention (CDC) report found that 69% of LGBTQ+ youth endorsed feeling persistently sad or hopeless compared to 35% of heterosexual youth. Despite these growing concerns, half of children with a treatable mental health condition do not receive care from a mental health specialist. Therefore, emergency departments (EDs) often serve to address unmet mental health needs. Despite the role of EDs in pediatric mental health, there are limited data examining mental health ED utilization among LGBTQ+ youth. Objective: This study aims to evaluate differences in ED utilization and disposition among LGBTQ+ and heterosexual/cis-gender youth presenting to a tertiary children’s ED for mental health treatment. Design/Methods: This retrospective cohort study will examine patients ages 5 through 17 years evaluated by the psychiatric emergency services (PES) at a tertiary children’s hospital between 1/1/2019 and 12/31/2021. The hospital’s Institutional Review Board approved this study. Data will be collected from the electronic health record (EHR) and captured in a dataset. The dataset will include youth ages 5-17 years who were referred to the hospital’s PES for further psychiatric evaluation following presentation to the ED for an acute mental and/or behavioral health concern. Data collected for each youth will include primary mental health billing diagnosis, final disposition, and sociodemographic variables, including patient age, sex, gender identity, sexual orientation, race, and ethnicity. Descriptive statistics and chi-square analyses will be used to compare primary mental health billing diagnosis, sociodemographic characteristics, and disposition between heterosexual/cis-gender and LGBTQ+ patients. Data extraction and analysis will be completed by February 2024.
