PC1031: Police Transports to a Pediatric Emergency Department Are Mostly for Mental Health Emergencies

Background: Children with mental health (MH) emergencies presenting to pediatric emergency departments (PEDs) are disproportionately increasing compared to other types of visits. Adult data on the increasing number of police-facilitated MH transports has led to alternatives such as the development of Police Crisis Intervention Teams. There is little literature describing the trends and characteristics of police-facilitated pediatric MH transports. Our objective is to describe the epidemiology, trends in utilization, and ED outcomes of pediatric patients transported to PEDs by police as stratified by MH and non-MH related complaints.

Methods: This was a retrospective cohort study of patients aged 5 to 18 years evaluated in two PEDs affiliated with a tertiary care children’s hospital from 1 January 2012 to 31 December 2020. MH was defined by a rubric of diagnostic codes and chief complaints. Data was abstracted from electronic hospital records. Descriptive statistics were used to compare children with MH complaints transported by police to those transported with other diagnoses. Trends of police transports in MH patients were studied over time.

Results: During the 9-year period, 4,526 total patients were transported to the PEDs by police, with greater than 90% of these patients presenting with MH-related chief complaints (Figure). As shown in the table, patients with MH complaints were significantly more likely to be younger (13.8 vs 14.7 years), female (47.0 vs 37.5%), white (44.6 vs 23.3%), p< 0.001 for all comparisons; they also had significant differences in insurance types (p < 0.001). In the PED, a sizable proportion of the MH patients transported by the police required mechanical or physical restraints (8.0%) and psychiatric medications (8.7%), and over half required admission (53.3%).

Conclusion: An annual average of over 400 children with MH emergencies transported by police in our community represent a unique challenge on police resources, especially given the degree of agitation and safety concerns as supported by their need for ED restraints and medications and high admission rates. This presents an opportunity to evaluate our community’s approach and police resources needed to safely transport children with MH emergencies.