Youth mental health-related presentations at a quaternary centre: Who comes, What are their needs, and Can we meet their needs

• Published in: Paediatrics & child health Vol. 27; no. 3; pp. 147 - 153
• Main Authors: Lee, Alison, Davidson, Jana, Black, Tyler, Kim, Grace G, Doan, Quynh
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.06.2022
• Subjects: Child & adolescent psychiatry; Community health care; Emergency medical care; Health care access; Mental health; Mental health care; Original; Pediatrics; Canada; Youth; Mental disorders; Child; Emergency medicine; Mental health
• ISSN: 1205-7088; 1918-1485
• DOI: 10.1093/pch/pxab091

Abstract Background Mental health issues are increasingly prevalent across Canada, reflected in rising presentations to emergency departments. To effectively address the needs of children and youth seeking mental health-related care in the emergency department and to judiciously use scarce mental health-related resources, we need to better identify the specific areas of psychosocial needs and accessibility of associated services. Objective To describe the types and severity of paediatric mental health-related presentations evaluated at a quaternary paediatric emergency department, and to explore the accessibility of community mental health-related resources. Methods We conducted a retrospective cohort study of children and youth presenting to a quaternary paediatric emergency department who were assessed using HEARTSMAP, a validated mental health assessment and management tool. We reported the proportion who sought care for a psychiatric, social, or youth health-related mental health complaint. We contacted community mental health-related resources for their estimated wait times to determine accessibility. Results Of 1,530 paediatric emergency presentations, 98.8% of patients had psychiatric issues (40.1% were severe), 78.0% of patients had social issues (17.1% were severe), and 71.5% had youth health issues (18.1% were severe). We contacted 123 community mental health-related resources. Community youth health and social services were somewhat accessible, with 50.0% and 38.7%, respectively, able to intake youth within a week of referral. Community psychiatric programs were least accessible, with 59.3% having wait times greater than 1 month. Conclusions Many psychiatric concerns presenting in paediatric emergency departments have complex psychosocial challenges requiring non-psychiatric support. A need exists for improved accessibility to community psychiatric programs. Graphical Abstract pxab091_graphical_abstract