Emergency Department Data Give Glimpse into Seasonal Trends in Mental and Behavioral Health Conditions Among School-Aged Children

CDC’s National Syndromic Surveillance Program’s (NSSP) monitoring of emergency department (ED) data showed a seasonal increase among children and adolescents ages 10–17 years for mental and behavioral conditions during the school year. These data showed that visits for eight mental and behavioral health conditions began increasing during the typical back-to-school period and remained elevated throughout the school year when compared to the summer. Increases begin at the start of the school year, which raises questions about the challenges children face at school. Findings in previous reports about child and adolescent mental health also show a striking seasonality in ED visit trends.

NSSP surveillance experts examined changes in the number and proportion of weekly ED visit data for mental and behavioral health conditions in January 2018 through June 2023 among U.S. children and adolescents aged 5–17 years, stratified by age group (5–9 years, 10–14 years, 15–17 years). To get further insight into the emotional health and well-being of U.S. children and adolescents in relation to the academic year, subject experts from multiple Centers at CDC collaborated with the Children’s Hospital at Vanderbilt, District of Columbia Office of the State Superintendent of Education, federal partners from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Department of Education, and frontline public health experts from eight health departments—Arizona, Colorado, District of Columbia, Kansas, Kentucky, New Mexico, North Carolina, and Tennessee.

Findings from this collaborative study show the value of systemic changes that prioritize protective factors (e.g., physical activity, social support, and inclusive school and community environments) and incorporate preparedness for increases in mental and behavioral health conditions during back-to-school planning.

Awareness of these data is the first step toward improving connections across children, parents, clinicians, and schools to protect children’s mental and behavioral health.

• Parents: You know your child best. Talk to your child’s healthcare professional if you have concerns about your child’s mental health or the way your child behaves at home, in school, or with friends. There are things you can do to work with your child’s school to reinforce behaviors that contribute to a healthy and supportive school environment.
• Healthcare professionals: Early diagnosis and appropriate treatment of mental health concerns, using evidence-based guidelines, are very important. Screening and referral during healthcare visits can support early identification.
• Teachers/School administrators: Early identification is important so that children can get the help they need before mental health concerns reach a crisis point. Schools, families, and healthcare professionals can work together if there are concerns about the mental health of a child in your school. This CDC toolkit for schools can help your school promote parent awareness about school connectedness and emotional well-being.

Resources

Seasonal Trends in Emergency Department Visits for Mental and Behavioral Health Conditions Among Children and Adolescents Aged 5–17 Years—United States, January 2018–June 2023 

Whole School, Whole Community, Whole Child (WSCC) model. WSCC is CDC’s framework for school health. The WSCC model is an integrated approach to improve each child’s cognitive, physical, social, and emotional development. Also included is a model to see the program in action and information on the role of families and communities.

CDC Websites: Children’s Mental Health, Adolescent Mental Health