Home Page

Researchers from Clemson University, Prisma Health and the University of South Carolina (UofSC) are launching a study focused on developing systems-based solutions to improve the safety and well-being of children with mental and behavioral health conditions that arrive in emergency departments.

“Mental health issues have been on the rise among children, and has been further exacerbated by the pandemic,” said Anjali Joseph, director of the Center for Health Facilities Design and Testing and professor in the Clemson University School of Architecture. “There is a shortage of adequate mental health resources in the community and this has resulted in an increasing number of kids with mental and behavioral health issues showing up in emergency rooms, which are really the worst place for them.”

A $2 million grant from the Agency for Healthcare Research and Quality (AHRQ) will allow a team of doctors and scholars to search for solutions to ensure that when children arrive in emergency rooms with mental and behavioral health needs, they can receive the care they need. The team will be led by Joseph, along with Dr. Ann Dietrich, the pediatric emergency department chief for Prisma Health Upstate, and Dr. Meera Narasimhan, chairwoman in the department of psychiatry at Prisma Health and special advisor to University of South Carolina President for Health Innovations.

“Mental health disorders have exploded in the pediatric population with the multiple organizations including the American Academy of Pediatrics declaring a National Emergency in Child and Adolescent Mental Health in 2022,” Dietrich explained. “Between 2010 and 2018, mental health concerns and suicide rates rose consistently, and in 2018 suicide was the second leading cause of death in children between 10-24 years of age.”

The study has three aims. The first aim is to analyze the ways that current emergency department workflows either help or hinder proper care for children’s mental and behavioral health needs. The second is to design human-centered work systems to improve care. The third is to integrate, implement and evaluate the new work systems.

“Chaotic emergency department environments warrant innovative solutions at a systems level to better meet the needs of children who present with mental health emergencies,” Narasimhan said.

Joseph, whose research specializes in health facilities design, said that most emergency departments were not designed for the needs of patients – especially children – with severe mental and behavioral health conditions who may not have any visible physical problems. Further, she said many emergency rooms lack adequate mental health professionals on call. The result is long wait times for patients in distress. She noted that BIPOC (Black, Indigenous and People of Color) children are disproportionately impacted by shortcomings in mental and behavioral health care.

The partnership with Prisma ensures that once solutions are found, they can be put into action immediately.

“Prisma plans to disseminate the strategies and designs we learn that have a positive impact on the care of children with mental health concerns to other facilities to improve care,” Dietrich said. “We will also support our teams in developing a deep understanding of the problem and to identify high priority interventions.”

The team will include an array of Clemson faculty from a variety of fields. Joseph will be joined by David Allison and and Arelis Moore de Peralta from the College of Architecture, Arts and Humanities; Kapil Chalil Madathil, Kevin Taaffe and David Neyens from the College of Engineering, Computing and Applied Sciences; and Heidi Zinzow and Veronica Parker from the College of Behavioral, Health and Social Sciences. From Prisma Health, Dr. Pete Loper, Dr. Karen Lommel, Dr. Lucy Easler and Amanda Caywood will also contribute to the research team.

“We are excited that this AHRQ grant offers a unique opportunity for a transdisciplinary team of researchers from Clemson, UofSC and Prisma Health to come together, explore and potentially offer an adaptable framework and pathway to better address the emergency department experience for mentally ill children in the great state of South Carolina,” Narasimhan said.