Geographic Trends in Pediatric Psychotropic Medication Dispensing Before and After the Start of the COVID-19 Pandemic

OBJECTIVE

This study examined trends and geographic variability in dispensing of prescription psychotropic medications to U.S. youths before and after the start of the COVID-19 pandemic.

METHODS

Using national data on prescription medication dispensing, the authors performed a cross-sectional study examining the monthly percent change in psychotropic medications dispensed (total N=95,639,975) to youths (ages 5-18 years) in 2020 versus 2019, across medication classes and geographic regions.

RESULTS

For many medications, more were dispensed in March 2020 than in March 2019 and fewer in April-May 2020 versus April-May 2019. Stimulants had the largest decline: -26.4% in May 2020 versus May 2019. The magnitude of the monthly percent change varied by region.

CONCLUSIONS

Fewer psychotropic medications were dispensed to U.S. youths after the start of the COVID-19 pandemic compared with 2019. Although some medication classes rebounded to prepandemic dispensing levels by September 2020, dispensing varied by class and region.

Treatment of Patients Presenting With Suicidal Behavior in North American Pediatric Emergency Departments

OBJECTIVE

This study sought to identify current practices for the treatment of patients presenting with suicidal ideation or a recent suicide attempt in pediatric emergency departments (EDs) in North America.

METHODS

From October 10, 2018, to January 19, 2020, the authors conducted a cross-sectional online survey on current practices of pediatric emergency medicine chiefs practicing in the United States and Canada.

RESULTS

Forty-six (34%) of 136 chiefs of pediatric emergency medicine responded to the survey. The three most frequent improvements chiefs reported they would like to see in the care of young patients with suicidal ideation or suicide attempt were easier access to mental health personnel for evaluations, having mental health personnel take primary responsibility for patient evaluation and treatment, and better access to mental health personnel for dispositional planning.

CONCLUSIONS

The findings highlight the need for better mental health care in pediatric EDs to serve patients at increased risk for suicide.

Social Determinants and Treatment of Mental Disorders Among Children: Analysis of Data From the National Survey of Children's Health

OBJECTIVE

This study examined associations between social determinants of health (SDoHs) and need for and access to psychiatric treatment for U.S. children.

METHODS

Data were from the 2019 National Survey of Children's Health, a nationally representative parent-proxy survey of U.S. children. Parents (N=29,433) completed self-report surveys and indicated whether their children needed and received psychiatric treatment.

RESULTS

In total, 3,425 children (12%) were reported to have an emotional, developmental, or behavioral problem for which they needed treatment or counseling. Additionally, 605 children (18% of those who indicated treatment needs) were reported to have not received psychiatric treatment in the past year. Several SDoHs were associated with greater need for treatment and lower likelihood of accessing treatment.

CONCLUSIONS

Findings highlight the need for greater attention to social and systemic influences on children's mental health. Addressing social determinants may be beneficial in improving mental health and facilitating access to treatment.

Addressing the Consequences of the COVID-19 Lockdown for Children's Mental Health: Investing in School Mental Health Programs

Children are likely to struggle with mental health consequences relating to the COVID-19 pandemic. School closures and home confinement increase the risk for emotional distress, domestic violence and abuse, and social isolation, as well as for disruption of sleep-wake and meal cycles, physical exercise routines, and health care access. As schools reopen, school mental health programs (SMHPs) incorporating universal approaches will be important for all children, and targeted approaches will be necessary for those more severely affected. Using their experience in Pakistan, the authors provide a roadmap for extending the World Health Organization's eastern Mediterranean region's SMHP to address the mental health consequences of COVID-19 among children globally.