Evidence record
Most Children Enrolled in Medicaid Did Not Receive Timely Suicide-Related Followup Care
- Audit organization
- Office of Inspector General, U.S. Department of Health and Human Services
- Publication date
- September 2025
- Source record
- Original document linked
Findings
5
Recommendations
2
Overall conclusion
Timely followup care after pediatric suicidal thoughts or behaviors is not consistently achieved across states; about half of cases did not have a followup visit within 7 days and 21 percent had none within 60 days; shortages of behavioral health providers and difficulties connecting children to care are key barriers; CMS concurred with the recommendation to provide targeted technical assistance to low-performing states.
Scope
Analysis of Transformed Medicaid Statistical Information System (T-MSIS) data from FY 2023 for 54 states and territories, including children aged 10–17 hospitalized or visiting an ED for suicidal thoughts or behaviors who were continuously enrolled in Medicaid or CHIP for at least 60 days post-discharge; evaluation of followup care timing, provider type, and state variation; includes appendices with followup rates by state and by child/plan characteristics.
Findings (5)
Each finding has a stable link.
- F-1274
In 2023, 224,759 Medicaid-enrolled children aged 10–17 were hospitalized or visited the emergency department for suicidal thoughts or behaviors; the analysis included 258,458 unique hospitalizations or emergency department visits (cases).
- F-1275
In 50 percent of reviewed cases, children did not receive a followup visit within 7 days of the hospitalization or ED visit for suicidal thoughts or behaviors.
- F-1276
In 21 percent of cases, there were no followup visits in the 60 days after discharge.
- F-1277
Among followup visits that occurred, 71 percent were with behavioral health providers; counselors accounted for 28 percent of visits, social workers 22 percent, psychiatrists/neurologists 19 percent, psychologists 17 percent, and psychiatric nurse practitioners 5 percent; the remaining 29 percent were with other providers.
- F-1278
Subject matter experts attributed the lack of timely followup visits to behavioral health provider shortages and difficulties connecting children to care.
Recommendations (2)
- R-1121
Assist low-performing States to better ensure that children at risk of suicide receive timely followup care.
Related finding F-1275 - R-1122
CMS should provide additional technical assistance to States, focusing on the 24 States identified in the report where more than half of children do not receive followup within 7 days, through webinars and periodic calls; share promising practices and resources for engaging non-behavioral health providers and for implementing brief interventions such as caring contacts and safety planning.
Related finding F-1275