711 A five-year review of mental health admissions to a general paediatric department in South-East Ireland

• Published in: Archives of disease in childhood Vol. 108; no. Suppl 2; pp. A371 - A372
• Main Authors: Kerswill, Suzanne, Kuhar, Maja, Attia Kalim
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.07.2023
• Subjects: Adolescents; Age; Capacitation; Child & adolescent psychiatry; Children; COVID-19; Departments; Diagnosis; Eating disorders; Emergency medical care; Emergency medical services; Epidemiology; Health care; Hospitals; Mental health; Morbidity; Overdose; Pandemics; Patients; Pediatrics; Psychiatry; Resource allocation; Self destructive behavior; Self-injury; Student Records; Sustainable development; Teenagers; Trends; Ireland
• DOI: 10.1136/archdischild-2023-rcpch.586
• ISSN: 0003-9888

ObjectivesMental health concerns are responsible for significant morbidity and mortality in the paediatric population (1,2). A growing number of paediatric mental-health presentations to emergency departments have been reported in the past decade in Ireland and around the world, (3,4) with a further spike in presentations during the COVID-19 pandemic (5). However, in our setting as in many others, mental-health support services to young people remain under-resourced.We set out to describe the scope and trends in paediatric mental-health admissions to Wexford General Hospital (WGH) in South-East Ireland over a five-year period in order to better understand the epidemiology and healthcare needs of our patients and to assist with appropriate resource allocation.MethodsWe conducted a descriptive, retrospective review of all mental-healthcare admissions to WGH paediatric ward from August 2016 to October 2021. All patients from the age of 5 to 18 years were included, using an existing patient register of all mental-health admissions.Results249 patients were included, 70% of which were female. Figure 1 details the characteristics of admissions in terms of diagnosis, duration of stay, readmission rates and age at admission.The most common single diagnosis was overdose (22%), followed by eating disorders (10%), suicidality (10%) and deliberate self-harm (9%). Co-morbid illness was common, with 23% of patients having more than one mental-health diagnosis. Readmission was frequent, with 32% of patients being readmitted at least once. 70% of patients were between 14 and 18 years of age, 26% were aged 11 to 14 and only 4% were aged between 5 and 11 years.Figure 2 shows the change in incidence of mental health admissions over time. Admission rates peaked in 2017 with 72 admissions, declining to 27 in 2019. Admission rates then rose to 35 patients in 2020, coinciding with the pandemic, and 45 admissions in the first 10 months of 2021. Admission rates for eating disorders rose during the pandemic, with a peak of 6 admissions in the first quarter of 2020.Abstract 711 Figure 1Conclusion249 Paediatric mental-health admissions and a cumulative 1095 admission days were recorded in WGH over the five-year period, constituting a significant burden of disease in a hospital which currently has no resident psychiatrist, social worker or psychologist. Readmissions were common. Adolescents aged 14 to 17 made up the majority of admissions. Greater capacitation is required to adequately care for these patients and to allow for smooth transitioning to adult services.Referenceswww.who.int. (n.d.). Adolescent mental health. [online] Available at: http://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health.Building the Future Children and the Sustainable Development Goals in Rich Countries UNICEF Innocenti Report Card 14 Children in the Developed World. (n.d.). [online] Available at: http://cdn.thejournal.ie/media/2017/06/unicef-child-wellbeing-report-card.pdfFitzgerald E, Foley D, McNamara R, Barret E, Boylan C, Butler J, Morgan S, Okafor I. (2020). Trends in Mental Health Presentations to a Paediatric Emergency Department. I. Irish Medical Journal, [online] 113(20). Available at: https://www.researchgate.net/publication/341381154_Trends_in_Mental_Health_Presentations_to_a_Paediatric_Emergency_DepartmentMaguire E, Glynn K, McGrath C, Byrne P. (2020) ‘Children, seen and heard: a descriptive study of all children (aged 12 years and under) referred for acute psychiatric assessment in Tallaght University Hospital over a 10-year period,’ Irish Journal of Psychological Medicine, Cambridge University Press, pp. 1–9.Ougrin D, Wong BH, Vaezinejad M, Plener PL, Mehdi T, Romaniuk L, Barrett E, Hussain H, Lloyd A, Tolmac J, Rao M, Chakrabarti S, Carucci S, Moghraby OS, Elvins R, Rozali F, Skouta E, McNicholas F, Kuruppuaracchi N, Stevanovic D. (2021). Pandemic-related emergency psychiatric presentations for self-harm of children and adolescents in 10 countries (PREP-kids): a retrospective international cohort study. European Child & Adolescent Psychiatry, [online] pp.1–13. doi:10.1007/s00787-021-01741-6.