A systematic review of management strategies for children’s mental health care in the emergency department: update on evidence and recommendations for clinical practice and research

Newton, Amanda S; Hartling, Lisa; Soleimani, Amir; Kirkland, Scott W.; Dyson, Michele P; Cappelli, Mario

doi:10.1136/emermed-2016-205939

Cited by 33 publications

(31 citation statements)

References 36 publications

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“…Standardizing and improving MH assessments in the ED is an active area of research, with evidence historically limited by methodologic shortcomings . This study assessed the reliability and feasibility of using HEARTSMAP as a standardized tool for evaluating pediatric psychosocial assessment documentation in the ED to ultimately aid in quality improvement.…”

Section: Discussionmentioning

confidence: 99%

“…Emergency programs have not kept pace with the increasing demand for pediatric MH‐related care due to insufficient funding, support, and training . Many EDs are poorly equipped to manage MH complaints and often lack standardized assessment methods to guide clinical decision making . As a result, EDs vary considerably in their MH care practices, most of which are not evidence based, while expected assessments (i.e., physical abuse assessments for suspicious injuries or suicidality assessments for self‐harm presentations) are often inadequate or entirely absent from ED medical records .…”

mentioning

confidence: 99%

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Reliability of HEARTSMAP as a Tool for Evaluating Psychosocial Assessment Documentation Practices in Emergency Departments for Pediatric Mental Health Complaints

Gill

Arnold

Nugent

et al. 2018

Academic Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Reliability of HEARTSMAP as a Tool for Evaluating Psychosocial Assessment Documentation Practices in Emergency Departments for Pediatric Mental Health Complaints

Gill

Arnold

Nugent

et al. 2018

Academic Emergency Medicine

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“…Nationally, ED data by age group using a narrow definition of MH diagnoses (ICD‐10‐AM F00 to F99 as the primary diagnosis, MH dx ), have been reported annually by the Australian Institute of Health and Welfare (AIHW) for 2004–05 to 2016–17, but no trends have been assessed. Given that mental illness is chronic, and different age groups, such as children (0–14 years), youth (15–24 years) and older people (more than 65 years) require different MH and treatment strategies, information on trends of MH‐related presentations by age group may be useful for service planning within EDs and the broader health system.…”

Section: Introductionmentioning

confidence: 99%

Trends of emergency department presentations with a mental health diagnosis by age, Australia, 2004–05 to 2016–17: A secondary data analysis

Tran

Lambeth

Sanderson

et al. 2019

Emerg Medicine Australasia

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Objectives: The present study aims to explore for Australia: (i) the trends of ED presentations with a mental health (MH) diagnosis by age group; and (ii) whether those trends differ from all ED presentations. Methods: ED presentations to Australian public hospitals, 2004-05 to 2016-17 were captured in the National Non-Admitted Patient Emergency Department Care Database. We assessed total change and annual rate of change in the number and rates of presentations per 10 000 population for all presentations and those with a MH principal diagnosis (ICD-10-AM F00 to F99, MH dx ). Multivariable regression was used to assess the trend of the proportion of MH dx presentations. Results: Between 2004-05 and 2016-17, children (0-14 years), followed by older persons (≥65 years) had the highest ED utilisation; while youth (15-24 years) and younger adults (25-34 years) predominated for MH dx overlook the growing impact of these sub-groups.

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“…Further, patients who require mental health care can disturb the routine and flow of the ED, and can place a greater demand on resources than medical or trauma patients 7 . Specialised screening tools and mental health consultants trained in paediatric medicine can reduce the likelihood of hospitalisation and the length of stay in the ED, and also ease security problems, 8 but they are not available in all EDs 8 , 9…”

mentioning

confidence: 99%

Paediatric mental and physical health presentations to emergency departments, Victoria, 2008–15

Hiscock

Neely

Lei

et al. 2018

Medical Journal of Australia

119

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Objectives: To identify trends in presentations to Victorian emergency departments (EDs) by children and adolescents for mental and physical health problems; to determine patient characteristics associated with these presentations; to assess the relative clinical burdens of mental and physical health presentations. Design: Secondary analysis of Victorian Emergency Minimum Dataset (VEMD) data. Participants, setting: Children and young people, 0–19 years, who presented to public EDs in Victoria, 2008–09 to 2014–15. Main outcome measures: Absolute numbers and proportions of mental and physical health presentations; types of mental health diagnoses; patient and clinical characteristics associated with mental and physical health presentations. Results: Between 2008–09 and 2014–15, the number of mental health presentations increased by 6.5% per year, that of physical health presentations by 2.1% per year; the proportion of mental health presentations rose from 1.7% to 2.2%. Self‐harm accounted for 22.5% of mental health presentations (11 770 presentations) and psychoactive substance use for 22.3% (11 694 presentations); stress‐related, mood, and behavioural and emotional disorders together accounted for 40.3% (21 127 presentations). The rates of presentations for self‐harm, stress‐related, mood, and behavioural and emotional disorders each increased markedly over the study period. Patients presenting with mental health problems were more likely than those with physical health problems to be triaged as urgent (2014–15: 66% v 40%), present outside business hours (36% v 20%), stay longer in the ED (65% v 82% met the National Emergency Access Target), and be admitted to hospital (24% v 18%). Conclusions: The number of children who presented to Victorian public hospital EDs for mental health problems increased during 2008–2015, particularly for self‐harm, depression, and behavioural disorders.

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A systematic review of management strategies for children’s mental health care in the emergency department: update on evidence and recommendations for clinical practice and research

Cited by 33 publications

References 36 publications

Reliability of HEARTSMAP as a Tool for Evaluating Psychosocial Assessment Documentation Practices in Emergency Departments for Pediatric Mental Health Complaints

Reliability of HEARTSMAP as a Tool for Evaluating Psychosocial Assessment Documentation Practices in Emergency Departments for Pediatric Mental Health Complaints

Trends of emergency department presentations with a mental health diagnosis by age, Australia, 2004–05 to 2016–17: A secondary data analysis

Paediatric mental and physical health presentations to emergency departments, Victoria, 2008–15

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