Factors Associated With Police Bringing Children to a Psychiatric Emergency Room.

OBJECTIVE: Sensational headlines describing police entanglements with young children have prompted questions about how often these incidents occur and why. The authors of this cross-sectional study examined the factors associated with police versus nonpolice arrivals to the psychiatric emergency room and those predicting subsequent police arrivals. METHODS: Electronic medical records of children ages 5.0-12.9 years brought to a comprehensive psychiatric emergency program (CPEP) at a university hospital were reviewed to determine whether a child was brought by police ("police arrival") in response to a 911 call by school personnel, a mental health or other medical professional, or a caregiver. Extracted data included the child's age, sex, race-ethnicity, family makeup, insurance status, arrival status, referral source, diagnosis, disposition, treatment, number of CPEP and police encounters, and occurrences of aggression and suicidality. Multilevel and ordinary logistic regression models were used to identify factors associated with a first and subsequent police arrival. RESULTS: Of 339 children with CPEP encounters from September 2017 to April 2018, 103 (30%) had had at least one police arrival. Children brought by police were more likely than peers brought by caregivers to be Black or Latinx, have Medicaid, come from families without two parents, and have aggressive outbursts or suicidal behavior. Results from multilevel logistic regression indicated that aggressive outbursts and suicidality were most significantly and consistently associated with experiencing both a first and subsequent police arrival. CONCLUSIONS: Clinical and sociodemographic differences in police arrivals highlight the need for a comprehensive systems approach for children, especially marginalized youths, who need psychiatric emergency care.

Debate: Exposing the most serious infirmity - racism's impact on health in the era of COVID-19.

The COVID-19 pandemic retells a story that other diseases like HIV, diabetes, and cancer have clearly internationally illustrated. Minorities in developed countries across the globe - especially those of African, Hispanic, and Native American descent - suffer a greater burden of disease than whites. The evidence of the cause and effect relationship of racism on mental and minority health outcomes is staggering. Racism and its influence on policy and important structural systems allow health inequities across racial and ethnic groups to persist. What's more troubling is how systemic racism impacts children from all races and has been perpetuated across many generations dating back hundreds of years. The impact of racial oppression is seen through intergenerational trauma which impacts youth in varying ways. For this article, we offer three areas in which racism causes healthcare disparities, intergenerational trauma, social determinants, and cultural mistrust. Effective policy change and a greater level of accountability must be placed on major systems including health care, to most fully counter racism's varied role in sustaining mental health inequities.