{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:11:44Z","timestamp":1787008304630,"version":"build-2736575974"},"reference-count":28,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Targeted research efforts in implementation and evaluation of telemental health care for U.S. youth are needed to increase accessibility to care. Before telehealth, children and families may wait weeks for psychiatric evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Increasing numbers of pediatric patients are reporting the need for mental health care when they present to region's rural emergency departments (EDs). Outcomes of telemental health services were evaluated, with a focus on treatment throughput and referral.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Observational 18-month program evaluation of outcomes for children age &lt;18 years (N\u2009=\u200987) who received physical and mental health assessment by an ED physician. Children who subsequently received a mental health diagnosis were treated by a psychiatrist via telemental health visits (September 2017\u2013May 2019) in 4 rural EDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The majority of children (ages 5\u201317) presented with depression- or anxiety-related disorders (49%) or suicidal ideation\/attempt or self-harm (46%), with substance abuse accounting for 5% of cases. Mean ED wait times were 29\u2009min [95% CI: 6\u201352\u2009min] for children admitted to inpatient (IP) care compared with 33\u2009min [95% CI: 22\u201343\u2009min] for those discharged to outpatient (OP) care. Mean length of stay (LOS) of 8\u2009h 56\u2009min [95% CI: 166\u2013906\u2009min] was observed for children admitted to IP care compared with mean LOS of 6\u2009h 58\u2009min [95% CI: 382\u2013454\u2009min] for those discharged to OP care (p\u2009=\u20090.072). For suicidality cases, children who were subsequently admitted to IP care experienced a significantly longer mean LOS of 12\u2009h 30\u2009min [95% CI: 279\u20131221\u2009min] compared with a mean LOS of 7\u2009h 13\u2009min [95% CI: 346\u2013520\u2009min; p\u2009=\u20090.015] for children discharged to OP care. Mean total payor reimbursements were significantly lower than actual ED costs (p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>ED wait times and LOS were lengthy overall. Future evaluation of an evidence-based peds mental health triage screening tool is needed to support rural ED providers in peds mental health treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Additional resources and strategic policy supports are needed to bridge the mental health care treatment gap for rural children to address critical prevention, screening, and reimbursement needs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/tmj.2019.0253","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T17:18:08Z","timestamp":1580750288000},"page":"1353-1362","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":57,"title":["Telehealth Increases Access to Care for Children Dealing with Suicidality, Depression, and Anxiety in Rural Emergency Departments"],"prefix":"10.1177","volume":"26","author":[{"given":"Roseanne Moody","family":"Fairchild","sequence":"first","affiliation":[{"name":"Richard Lugar Center for Rural Health, Union Hospital, Terre Haute, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiaw-Fen","family":"Ferng-Kuo","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, Indiana State University, Terre Haute, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hicham","family":"Rahmouni","sequence":"additional","affiliation":[{"name":"Richard Lugar Center for Rural Health, Union Hospital, Terre Haute, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hardesty","sequence":"additional","affiliation":[{"name":"Richard Lugar Center for Rural Health, Union Hospital, Terre Haute, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12116"},{"key":"e_1_3_4_3_2","unstructured":"McCance-Katz EF et al. Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC). 2017. Report to Congress: \u201cThe Way Forward: Federal Action for a System That Works for All People Living with Serious Mental Illness (SMI) and Serious Emotional Disturbance (SME) and Their Families and Caregivers.\u201d U.S. Department of Health and Human Services (DHHS) December 13 2017. Available at https:\/\/www.samhsa.gov\/sites\/default\/files\/programs_campaigns\/ismicc_2017_report_to_congress.pdf (last accessed August12 2019)."},{"key":"e_1_3_4_4_2","unstructured":"Health Resource Services Administration's (HRSA) Rural Health Information (RHI) Hub \u201cWhat are the workforce challenges in providing rural mental health services?\u201d Available at https:\/\/www.ruralhealthinfo.org\/topics\/mental-health#statistics (last accessed September3 2019)."},{"key":"e_1_3_4_5_2","volume-title":"Trends in emergency department visits, 2006\u20132014. 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