Technological barriers to providing pediatric mental and behavioral healthcare in emergency departments.

In the United States, about 5% of pediatric Emergency Department (ED) visits involve mental and behavioral health (MBH) emergencies, and EDs are often ill-equipped to provide timely, appropriate care, leading to prolonged stays and increased risks of trauma and harm for these children and their families. This study investigated technological barriers affecting safe and effective pediatric mental and behavioral healthcare in emergency departments through observational studies and semi-structured interviews with 55 medical professionals across four ED settings: pediatric MBH unit, pediatric ED, and adult ED. A total of 12 barrier themes were identified through the thematic analysis of the interviews relating to technology use that impacts the care of pediatric MBH patients. The major themes include issues due to limited electronic medical record data management, ineffective communication in the ED, and usability issues with ED technologies. Other concerns included inadequate infrastructure, absence of streamlined processes, unsafe and inefficient integration of technology, and lack of training. Challenges stemming from patients' reluctance to accept telepsychiatry further complicate providing effective care in these settings. Future research needs to focus on designing systems and solutions to eliminate the barriers, thereby supporting the caregiving process of pediatric MBH in EDs.