Hospitals across Illinois are making progress in caring for children experiencing mental health crises but continue to face significant challenges, especially limited access to specialists and long waits for psychiatric care, according to a survey of Illinois emergency departments published in the Journal of American College of Emergency Physicians Open on July 8.
The study surveyed 65 emergency departments participating in the Illinois Pediatric Facility Recognition Program, which supports pediatric emergency readiness based on core requirements. About half of the state's emergency departments participate in this program, established in 1998 as one of the earliest state regulatory designations for pediatric emergency care. As of 2023, similar programs exist in 23 states.
Nearly two out of three responding emergency departments were located in hospitals without a pediatric inpatient unit, highlighting that many children receive mental health care outside specialized facilities. About one in five respondents were from critical access hospitals serving communities where access to pediatric mental health specialists may be especially difficult. The survey found that only 56% reported having onsite mental health professionals, while another 44% used telemental health services.
"We identified that a key gap in emergency care was timely access to evaluation by a mental health professional, particularly those with pediatric-specific expertise," said Dr. Hoffmann.
Eighty-one percent of surveyed departments identified limited availability of follow-up services—such as ongoing community care or psychiatric hospitalization—as a top barrier after an initial visit. Seventy percent cited prolonged waits for psychiatric placement as a major challenge; more than three-quarters reported at least one child waiting over three days within the past year for appropriate psychiatric care.
"Children experiencing a mental health crisis should not have to wait days in an emergency department for the care they need. We would never allow a child with a broken leg to wait three days for surgery. We should apply those same standards to children with mental health needs," said Dr. Hoffmann.
Most responding departments (88%) screened children for suicide risk regardless of their reason for visiting; however, only about half consistently followed recommended steps to prepare families to keep children safe from self-harm at home.
"It is encouraging that most emergency departments are screening children for suicide risk," said Dr. Hoffmann. "The next challenge will be making sure that families leave the emergency department with a clear plan for keeping their child safe and getting help."
Michelle M. Barnes, MD, FAAP, President of the Illinois Chapter of the American Academy of Pediatrics, said, "These survey findings highlight important differences in pediatric behavioral health care processes and resources across emergency departments, along with shared barriers and clear opportunities for improvement. They point to the need for stronger coordination and greater consistency across Illinois' pediatric mental health care system."
