CISWH Experts Highlight Increased Psychosocial Referrals Among Children in Emergency Care During COVID-19 Pandemic

The COVID-19 pandemic reshaped how children and families accessed health care, placing intense, new demands on emergency departments (EDs). In a recent article published in Social Work in Health Care, researchers from the Center for Innovation in Social Work and Health (CISWH) at BU School of Social Work (BUSSW), the University of Hawai’i at Manoa, and Boston Children’s Hospital (BCH) examined how referrals to psychosocial services in a pediatric emergency department changed following the onset of the pandemic. 

Using data from more than 70,000 encounters before and 44,000 during the pandemic, the study compared referrals before and during the COVID-19 state of emergency across general, psychiatric and child protection social work services. 

The research team included Dr. Christina Lee, faculty director of the CISWH Health Equity Research Lab; Dr. Mihoko Maru (PhD’20, MSW’15), assistant professor of the Department of Social Work at the Thompson School of Social Work and Public Health at the University of Hawai’i at Manoa; and collaborators from BCH led by Pamela Chamorro, director of social work; Dr. Elizabeth Boskey, co-director of research in the division of gynecology; and Dr. Hiu-fai Fong, pediatrician in the Child Protection Program. 

The study identified several key findings: 

More children needed support for social and mental health needs – While fewer children came to the emergency department overall, a larger share needed help with social or mental health concerns. Referrals increased from 10.9% to 15.2%, showing a higher level of need among those who did seek care. 

Largest increases in referral were for child protection social work services – While referrals went up for general, psychiatric, and child protection social work services, the largest increase was in child protection, pointing to growing concerns around family stress and child safety. 

Changes in how clinically acute cases were – Child protection-related encounters became more severe, while psychiatry-related encounters were slightly less severe on average. This may reflect changes in how and where children were able to get mental health care during the pandemic. 

These findings highlight the essential role of social workers in emergency care settings, particularly during public health crises. As EDs became a key access point for both medical and psychosocial support during the pandemic, the authors emphasized the need for stronger integration of social work into emergency preparedness and response efforts. 

Read the full article here.