Trends in U.S. Emergency Department Visits for Mental Health Conditions, 1992 to 2001

OBJECTIVE: The objective of this study was to ascertain trends in mental health-related visits to U.S. emergency departments. METHODS: Data were obtained from the National Hospital Ambulatory Medical Care Survey by using mental health-related ICD-9-CM, E, and V codes as well as mental health-related reasons for visit. RESULTS: From 1992 to 2001, there were 53 million mental health-related visits, representing an increase from 4.9 percent to 6.3 percent of all emergency department visits and an increase from 17.1 to 23.6 visits per 1,000 U.S. population across the decade. The most prevalent diagnoses were substance-related disorders (22 percent of visits), mood disorders (17 percent), and anxiety disorders (16 percent). Mental health-related visits increased significantly among non-Hispanic whites, patients older than 70 years, and patients with insurance. Medications were administered during 61 percent of all mental health-related visits, most commonly psychotropic medication, the prescription rate of which increased from 22 percent to 31 percent of visits over the decade. Ten-year increases in mental health-related emergency department visits were significant for all U.S. geographic regions except the Midwest. CONCLUSIONS: Mental health-related visits constitute a significant and increasing burden of care in U.S. emergency departments.