Behavioral health needs of newcomer patients in a pediatric emergency department

Newcomers, immigrants of various legal designations, face multiple stressors impacting their wellbeing, including pre-existing psychiatric diagnoses and emerging concerns related to migration, which contribute to barriers accessing behavioral health and medical care. As such, they are more likely to seek care in emergency department (ED) settings than primary care and commonly present to safety-net institutions. Capitalizing on such systems and improving pathways to care can help reduce barriers and improve access to behavioral health care for this population. However, there is limited understanding of current behavioral health concerns and practices in EDs, particularly for the newcomer population. We conducted secondary analyses of deidentified data collected as part of routine practice at a safety-net hospital serving youth patients and their families who have recently arrived in the United States. We describe encounter-level clinical data for newcomer youth evaluated by an integrated psychology service in a pediatric ED setting. Newcomer patients faced behavioral health concerns and social stressors that often were not their chief complaint. Additionally, about one-third of newcomer patients accepted referrals for follow-up care with this number dropping in Fall 2024. Findings highlight a need for tailored, trauma-informed care delivered in spaces commonly accessed by this population. Integrated psychology services in EDs show promise for identifying concerns and improving access to care for newcomer patients.