The Effect of a Dedicated Psychiatric Team to Pediatric Emergency Mental Health Care

Sheridan, David C.; Sheridan, John S.; Johnson, Kyle; Laurie, Amber; Knapper, Allyson; Fu, Rongwei; Appy, Shannon; Hansen, Matthew

doi:10.1016/j.jemermed.2015.10.034

Cited by 42 publications

(76 citation statements)

References 13 publications

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“…After the first year of implementation, they found reductions in all the following: average length of ED stay from 235 to 190 min; use of security personnel from 54 to 17 h per 100 patients; and physical and chemical restraint use from 1.5 to 0.6 incidents per 100 patients. Placing a mental health team in the pediatric ED of the Oregon Health Sciences University led to a 27% reduction in ED length of stay and an 18% decline in inpatient admissions, with no change in the frequency of return visits over a 1-year period (Sheridan et al, 2016 ).…”

Section: Categories Of Informationmentioning

confidence: 99%

Emergency Department Use by Children and Youth with Mental Health Conditions: A Health Equity Agenda

Hoge

Vanderploeg

Paris

et al. 2022

Community Ment Health J

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There are growing concerns regarding the referral of children and youth with mental health conditions to emergency departments (EDs). These focus on upward trends in utilization, uncertainty about benefits and negative effects of ED visits, and inequities surrounding this form of care. A review was conducted to identify and describe available types of data on ED use. The authors’ interpretation of the literature is that it offers compelling evidence that children and youth in the U.S. are being sent to EDs for mental health conditions at increasing rates for reasons frequently judged as clinically inappropriate. As a major health inequity, it is infrequent that such children and youth are seen in EDs by a behavioral health professional or receive evidence-based assessment or treatment, even though they are kept in EDs far longer than those seen for reasons unrelated to mental health. The rate of increase in these referrals to EDs appears much greater for African American and Latinx children and youth than White children and is increasing for the publicly insured and uninsured while decreasing for the privately insured. A comprehensive set of strategies are recommended for improving healthcare quality and health equity. A fact sheet is provided for use by advocates in pressing this agenda.

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Section: Categories Of Informationmentioning

confidence: 99%

Emergency Department Use by Children and Youth with Mental Health Conditions: A Health Equity Agenda

Hoge

Vanderploeg

Paris

et al. 2022

Community Ment Health J

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“…While the overall prevalence of mental health conditions in youth has remained relatively stable [1], many recent studies have reported an increase in psychiatric emergencies in children and adolescents. Such increase has been noted in the United States [2][3][4][5], Canada [6][7][8], and Europe [9][10][11]. Over the same period, most countries have reduced the number of child and adolescent psychiatric inpatient beds [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Predictors of voluntary and compulsory admissions after psychiatric emergency consultation in youth

Wierdsma

Kasius

et al. 2020

Eur Child Adolesc Psychiatry

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As hospital beds are scarce, and emergency admissions to a psychiatric ward are major life-events for children and adolescents, it is essential to have insight into the decision-making process that leads to them. To identify potentially modifiable factors, we, therefore, studied the contextual and clinical characteristics associated with the voluntary and compulsory emergency admission of minors. We used registry data (2008-2017) on 1194 outpatient emergencies involving children aged 6-18 who had been referred to the mobile psychiatric emergency service in two city areas in The Netherlands. Demographic and contextual factors were collected, as well as clinical characteristics including diagnoses, psychiatric history, Global Assessment of Functioning (GAF), and the Severity of Psychiatric Illness (SPI) scale. Logistic regression analyses were used to identify factors that predict voluntary or compulsory admission. Of 1194 consultations, 227 (19.0%) resulted in an admission, with 137 patients (11.5%) being admitted voluntarily and 90 (7.5%) compulsorily. Independently of legal status, the following characteristics were associated with admission: severity of psychiatric symptoms, consultation outside the patient's home, and high levels of family disruption. Relative to voluntary admission, compulsory admission was associated with more severe psychiatric problems, higher suicide risk, and prior emergency compulsory admission. Two potentially modifiable factors were associated with psychiatric emergency admission: the place where patients were seen for consultation, and the presence of family problems. Psychiatric emergency admissions may be reduced if, whenever possible, minors are seen in their homes and if a system-oriented approach is used.

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“…This study aimed to gain a better understanding of the resources available to pediatric patients serviced by a tertiary care pediatric ED. Given previously described trends of increased ED utilization and high rate of return within 2 months, 4,8 we hypothesized that follow-up often occurred with primary care providers and that follow-up was delayed, occurring more than 1 month after initial ED visit. However, our data did not show this.…”

Section: Discussionmentioning

confidence: 99%

Access to Outpatient Pediatric Mental Health Care After Emergency Department Discharge

Sheridan¹,

Marshall

Morales³

et al. 2020

Pediatr Emer Care

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Objectives: Pediatric mental health presentations to emergency departments (EDs) have shown dramatic increases nationally. This study aimed to identify the ability of patients discharged with mental health from the ED to establish outpatient care.Methods: This was a cross-sectional study of all mental health patients aged 7 to 19 years who were seen by a child psychiatry consult team in a tertiary care pediatric ED from September 2016 to January 2017. Patients were contacted by phone at least 6 months after discharge. Data obtained included time to follow-up, reasons for delayed follow-up, type of provider seen, and frequency of outpatient visits.Results: Two hundred twenty-eight charts were reviewed and 51 were successfully interviewed. The median age was 14 years and 61% were female. Most patients (61%) reported seeing a psychiatrist or therapist, whereas 19% reported a primary care provider and 19% reporting "other."The majority were able to establish care within 1 month (73%), whereas 9% reported never obtaining outpatient follow-up. Most patients (58%) were able to be seen more than once per month. The most common reason for delayed follow-up was provider availability.Conclusions: This study found that a large number of patients were able to be seen within 1 month of discharge for mental health care. However, almost 10% of patients never established outpatient care, which is concerning and is an area needing further research.

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The Effect of a Dedicated Psychiatric Team to Pediatric Emergency Mental Health Care

Cited by 42 publications

References 13 publications

Emergency Department Use by Children and Youth with Mental Health Conditions: A Health Equity Agenda

Emergency Department Use by Children and Youth with Mental Health Conditions: A Health Equity Agenda

Predictors of voluntary and compulsory admissions after psychiatric emergency consultation in youth

Access to Outpatient Pediatric Mental Health Care After Emergency Department Discharge

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